Trevor J. Dorkin

Discontinuation rates and inter-injection interval for repeated intravesical botulinum toxin type A injections for detrusor overactivity

To report discontinuation rates, inter‐injection interval and complication rates after repeated intravesical botulinum toxin type A for the treatment of detrusor overactivity.

The management of bilateral ureteric injury following radical hysterectomy.

Iatrogenic ureteric injury is a well-recognised complication of radical hysterectomy. Bilateral ureteric injuries are rare, but do pose a considerable reconstructive challenge. We searched a prospectively acquired departmental database of ureteric injuries to identify patients with bilateral ureteric injury following radical hysterectomy. Five patients suffered bilateral ureteric injury over a 6-year period. Initial placement of ureteric stents was attempted in all patients. Stents were placed retrogradely into 6 ureters and antegradely into 2 ureters. In 1 patient ureteric stents could not be placed and they underwent primary ureteric reimplantation. In the 4 patients in which stents were placed, 2 were managed with stents alone, 1 required ureteric reimplantation for a persistent ureterovaginal fistula, and 1 developed a recurrent stricture. No patient managed by ureteric stenting suffered deterioration in serum creatinine. We feel that ureteric stenting, when possible, offers a safe primary management of bilateral ureteric injury at radical hysterectomy.

Intermittent self‐dilatation for urethral stricture disease in males: A systematic review and meta‐analysis

Intermittent self‐dilatation (ISD) may be recommended to reduce the risk of recurrent urethral stricture. Level one evidence to support the use of this intervention is lacking.

Quantifying the effect of urodynamic catheters on urine flow rate measurement.

The effect of urodynamic catheters on urine flow rate (Qmax) is well documented but under‐researched. Several studies show reduced Qmax but methodologies and patient demographics differ. The aims of this study were to further quantify the effect of urodynamic catheters on Qmax and to explore if this was consistent across different urodynamic diagnoses.

Is low bladder compliance predictive of detrusor overactivity

Bladder compliance (BC) expresses the relationship between bladder volume and bladder pressure and is generally regarded as a measure of bladder stiffness or distensibility. Many types of voiding dysfunction have been associated with low BC such as detrusor overactivity (DO). It has previously been reported that the presence of DO is an independent predictor of low BC. The aim of this study was to assess the predictive value of low BC for the diagnosis of idiopathic DO using ambulatory urodynamics as the gold standard investigation for comparison.

British Association of Urological Surgeons (BAUS) consensus document for the management of male genital emergencies ‐ testicular trauma

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on‐site expertise in genitourethral surgery. A series of consensus statements have been developed by an expert consensus comprising British Association of Urological Surgeons (BAUS) Section of Andrology and Genitourethral Surgery together with experts from units throughout the UK. Testicular trauma requires prompt investigation and treatment in order to prevent the development of subfertility or hypogonadism. This series of consensus statements provide guidance for UK practice.

BAUS consensus document for the management of male genital emergencies: priapism

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on‐site expertise in genitourethral surgery. A series of consensus statements have been developed by an expert consensus committee comprising members of the BAUS Section of Andrology and Genitourethral Surgery together with experts from urology units throughout the UK. Priapism requires prompt assessment and treatment and these consensus statements provide guidance for UK practice.

Is there any value investigating persistent haematospermia? Results of a 12-year prospective study

Objectives: We hypothesise that haematospermia, with no additional clinical features and regardless of age, does not warrant investigation as abnormal pathology is rarely found. Patients and methods: Twelve-year prospective data were collected on men referred with persistent haematospermia. Patients were divided into two age groups: less than 40 years and greater than 40 years. Patients were assessed through history and clinical examination including a DRE, serum PSA and a TRUS — with or without biopsy. Results: Fourteen men under 40 presented with haematospermia. TRUS showed calcification in 2 patients. No malignancy was detected in this sub-group. Conclusion: Mono-symptomatic haematospermia — regardless of age — requires only limited investigation as the condition is invariably benign. Prostate biopsies should only be considered if an elevated PSA and/or abnormal DRE are detected.

BAUS Consensus Document for the Management of Male Genital Emergencies - Penile Fracture

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on‐site expertise in genitourethral surgery. The aim of these consensus statements is to provide best practice guidance for urological surgeons based in the UK which are developed by an expert consensus. Penile fracture is a rare emergency and in most cases requires prompt exploration and repair to prevent erectile dysfunction and penile curvature.

BAUS Consensus Document for the Management of Male Genital Emergencies - Penile Amputation

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on‐site expertise in genitourethral surgery. A series of consensus statements have been developed by an expert consensus committee comprising members of the British Association of Urological Surgeons (BAUS) Section of Andrology and Genitourethral Surgery together with experts from urology units throughout the UK. Penile amputation is a rare genital emergency, which requires prompt intervention and microsurgical reconstruction. The consensus statements will outline the management of these cases for non‐specialist units, as well as recommendations for reconstruction for specialists.