Journal of Clinical Urology

24-h frequency-volume (FV) charts are often used to assess patients with lower urinary tract symptoms suggestive of bladder outflow obstruction (LUTS/BOO). There are no clear guidelines regarding the optimum chart duration. We aimed to determine whether a one-day FV chart is representative of a 3-day equivalent.

Men presenting with LUTS (including nocturia) were prospectively recruited and completed a 3-day FV chart. Exclusion criteria were previous bladder outflow surgery and anti-cholinergic medication.

285 patients were recruited (mean age, 67 years; range 26–93 years). There were no significant inter-day differences in 24-h urine volume (24HUV) (p = 0.10) and functional bladder capacity (FBC) (p = 0.19). However, there were significant differences identified between days 1 and 2, and 1 and 3 for both nocturnal urine volume (NUV) (p < 0.001) and actual nocturnal voids (ANV) (p < 0.001) despite significant correlation of these parameters on each day with their respective 3-day means.

Our data suggest that a one-day FV chart is representative of a 3-day equivalent for the assessment of 24HUV and FBC in patients with LUTS/BOO. Further studies are required to compare the repeatability and clinical utility of a one-day chart compared with 3- and 7-day charts, particularly in patients with nocturia.

To review patients presenting in a specialist macroscopic (visible) haematuria clinic during 2005, incorporating 3 years of follow-up, and to assess the role of urine cytology.

All patients attending the 2005 macroscopic haematuria clinic were identified. All subsequent admissions, pathology and imaging for each patient were captured from the hospital IT system during 3 years of follow-up and reviewed retrospectively.

Five hundred and three patients were assessed. No significant abnormalities were diagnosed in 52%, benign disease in 27% and malignant disease in 21% (including 14% urothelial cancer, 3% renal cancer and 4% prostate cancer). All bladder tumours were diagnosed with flexible cystoscopy and the 3 upper-tract urothelial tumours by ultrasound. Overall, cytology had a sensitivity of 66% and specificity 90% but did not diagnose tumours that were not identified with other investigations. Patients with abnormal cytology without apparent cause underwent various investigations including IVU, cystoscopy and biopsy and no tumours were identified. After 3 years no occult diseases became apparent.

Half of all those attending with visible haematuria had significant urological diagnoses (21% urological cancer). Urine cytology did not appear to add significant information in the initial assessment of visible haematuria.

Kidney transplantation is the best treatment available for end stage renal disease at any age. Vesicoureteric reflux (VUR) following paediatric renal transplant can lead to loss of graft function. We present a summary of a survey evaluating current surgical techniques used for vesicoureteric anastomosis in paediatric renal transplantation in the United Kingdom (UK) developed in our unit.

In the UK, 70% of paediatric transplant surgeons use the Lich—Gregoir technique and 70% place a transanastomotic double-J stent at the time of vesicoureteric anastomosis. 80% of the double-J stents are removed at 6 weeks following transplant.

Paediatric renal transplant grafts are at risk of developing segmental pyelonephritic scars if infected urine refluxes into the graft either through a transanastomotic stent or later from vesicoureteric anastomosis. These scars may reduce the renal function with time. Consideration should be given within the UK for the development of more effective anti-reflux surgery for vesicoureteric anastomosis in paediatric renal transplantation.

A diminishing number of surgeons are performing paediatric groin surgery in large district general hospitals due to loss of expertise. The British Association of Urological Surgeons (BAUS) is currently engaged with the Royal College of Surgeons (RCS) to resolve this gradual loss of subspecialist expertise.

We have adopted a user-friendly approach to quantify training in this field.

In our centre we undertake approximately 150 paediatric groin cases per year with 3 specialist registrars (SpRs) rotating through the post every 4 months. Using existing Intercollegiate Surgical Curriculum Project (ISCP) tools, Direct Observation of Procedural Skill (DOPS) assessments were undertaken for each groin procedure performed by the SpR then scored by the trainer from 2 (unsatisfactory) to 6 (above expectations), with 4 being considered satisfactory/competent to perform the procedure. Three SpRs were assessed over a period of 4 months each.

Competency was determined by 5 successive DOPS scores of 4. Case numbers over 4 months were 23–35 with a mean number of cases to achieve competency being 16 (range 10–18).

These results indicate that it is feasible and practical for a trainee to acquire adequate experience in DGH paediatric groin surgery and we suggest a minimum performance of 25 procedures.