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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...Demanding cases or nightmares in endourology? May/June 2017
In the sixth article in this series the authors describe endourology nightmares involving ileal conduits and calculi. Case 1 A 69-year-old man who had a cystectomy and ileal conduit for muscle invasive bladder cancer, presented with an acute kidney injury...A guide for the assessment and management of post-obstructive diuresis
Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...
Do stones still kill?
This paper is a retrospective analysis of deaths ascribed to stone disease in England and Wales over a 15-year period. The data was obtained from the Office of National Statistics, based on mortality derived from death certificates. One thousand, nine...New techniques in UTI diagnosis
Urinary tract infection (UTI) is a common reason for seeking medical care in both primary and secondary settings. Half of women will have at least one episode of cystitis in their lifetime, and a third of them will have experienced...Management of urological issues following genital gender affirmation surgery for individuals assigned female at birth
Gender incongruence arises when there is a mismatch between an individual’s gender identity and their sex assigned at birth. Genital gender affirmation surgery (GAS) is the final step of transition for transgender and non-binary individuals who experience gender incongruence. This...Suprapubic catheterisation – a core surgical trainee’s perspective
Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...
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...
Synthetic mid-urethral slings for stress incontinence in neurogenic LUTD
Neurogenic lower urinary tract dysfunction (NLUTD) is heterogeneous because of the multiplicity of underlying causes and mechanisms. In women with NLUTD, stress urinary incontinence may be due to intrinsic sphincter deficiency caused by the neurological disease itself or from sphincter...
Prenatal spina bifida repair – does it have urological benefits in the longer term?
At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....
Ureterocystostomy – novel surgery for the paediatric obstructed megaureter
Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...
