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Antimuscarinics and behaviour in patients with spinal dysraphism

Since the 1980s patients with spinal dysraphism have had aggressive bladder management with clean intermittent catheterisation and anticholinergic therapy from early on in life. This strategy aims at improving lower and therefore upper urinary tract function thus decreasing the risk...

The impact of menopause on bladder symptoms

The menopause is a natural process of ageing when the ovaries completely stop producing reproductive hormones (oestrogen and other sex steroids), and there are no monthly periods for 12 consecutive months. It normally occurs between the ages of 45-55 years...

Biomarkers in prostate cancer detection

Prostate cancer (PCa) is the second most common cancer in men with an estimated prevalence of 1.1 million worldwide in 2012. This heterogeneous disease resulted in approximately 307,000 deaths, making it the fifth leading cause of cancer-related death in men...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...

A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

Nuptial night tragedy

Case 1 A fit and well 50-year-old gentleman presents to the emergency department with pain and swelling of his penis that started a few hours after he had a shower earlier in the day. On examination, the appearance is as...

Systematic reviews and meta-analysis – a stepwise approach

As per Cochrane definition (2013), a systematic literature review (SR) attempts “to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question” [1]. A meta-analysis (MA) is a statistical assessment of...

Urethral diverticulum: a review of the literature and local experience

Urethral diverticula are an uncommon finding on imaging. They are focal outpouchings of the urethra into the periurethral / urethrovaginal space, occurring more frequently in females (up to 6% of women) [1]. These diverticula are becoming more prevalent in clinical...

Genital gender affirmation surgery for transgender men

Genital gender affirmation surgery (GAS) is the final step in the transition journey for transgender men. Genital GAS involves a combination of procedures to surgically align physical characteristics with one’s gender identity. These needs change between each individual depending on...

Hail the Portfolio Pathway!

In the United Kingdom, the pursuit of a surgical career traditionally follows a conventional pathway, primarily through the completion of specialty programmes accredited by the Royal College of Surgeons or the Intercollegiate Surgical Curriculum Programme (ISCP). However, for doctors with...