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Laparoscopic transposition of renal lower pole crossing vessels

The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...

Pre-transplant management of valve bladder

This paper examines the evidence concerning the timing, indications and problems associated with augmentation cystoplasty (AC), posterior urethral valves (PUV), and end stage renal failure (ESRF) using a literature review via Medline, Cochrane library and LILACS databases. Two search strategies...

ICS updates on continence care: making sense of detrusor underactivity and the underactive bladder

Countless epidemiological studies have established the frequent occurrence of lower urinary tract symptoms (LUTS) and the significant burden these symptoms incur. For the most part of the past three decades, there has been an overwhelming focus on detrusor overactivity (DO)...

Children with neuropsychiatric developmental disorders respond less well when treated for bladder bowel dysfunction

Bladder and bowel dysfunction (BBD) is a spectrum of lower urinary tract symptoms and voiding dysfunction accompanied by functional constipation and / or encopresis and may represent up to 47% of paediatric urology consultations. The BBD cycle pattern begins when...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

Giggle incontinence – not a laughing matter!

For many decades, the condition of giggle incontinence (enuresis risoria, giggle micturition) has remained a rare and poorly understood condition. Patients (90% female) present in their teens, with the history revealing an issue for many years. It is debilitating and...

Dual therapy for OAB in children

Overactive bladder (OAB) is a disorder frequently encountered by the paediatric urologist. Morin et al. report the results of the first known study on the efficacy of mirabegron (a β3 adrenoceptor agonist) as add-on therapy in paediatric patients with refractory...

Relax and take note of this!

Children with neurogenic bladders are at risk of renal compromise through high detrusor pressures. Management aims to provide continence and preserve the upper tracts by increasing capacity and compliance though early clean intermittent catheterisation and anticholinergics. Intradetrusor botulinum toxin has...

Cystitis Unmasked

Cystitis is often viewed as a heartsink diagnosis, and sometimes one of exclusion. The aetiology is multifactorial and misunderstood. Treatment has been based on dogma, and poor clinical and scientific evidence. The truth is, that despite the significant morbidity caused...

Predictors of vaginal mesh exposure after mid-urethral sling placement

Vaginal mesh exposure following mid-urethral sling (MUS) insertion can be a difficult complication to treat. The aim of this study was to identify possible risk factors in patients who had unfortunately developed vaginal mesh exposure following MUS surgery. This was...

An overview of changes to urology training

Paediatric urology training A review of paediatric emergency services in the UK involving general surgery, urology and paediatric surgery was initiated due to the problems encountered by the lack of suitable experience outside large paediatric surgical units to deliver emergency...

Nocturnal enuresis in children

Introduction Nocturnal enuresis is the complaint of bedwetting. The 2010 National Institute for Health & Care Excellence (NICE) guidelines define bedwetting as the “involuntary wetting during sleep without any inherent suggestion of frequency of bedwetting or pathophysiology” [1]. Bedwetting is...