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The diagnostic approach to ureteric colic has changed due to the introduction of new radiological imaging such as non-contrast CT. The role of intravenous urography, which is regarded as the gold standard for the diagnosis of ureteric colic, is being challenged by CT, which has become the first-line investigation in a number of centres. The management of ureteric colic has also changed. The role of medical treatment has expanded beyond symptomatic control to attempt to target some of the factors in stone retention and thereby improve the likelihood of spontaneous stone expulsion.

Although the incidence of mumps orchitis has dramatically declined since the introduction of the childhood vaccination programme, a sharp increase in reported cases of both mumps and mumps orchitis has been seen recently in the UK. There are great concerns about mumps outbreaks and the associated risk of infertility; it remains an important clinical condition. Immunization is the best policy to avoid this viral disease.

Penile fracture is an uncommon urological emergency that can have significant complications. Patients usually present to the accident and emergency department, but may seek advice from GPs. Immediate surgical repair is the treatment of choice, with fewer complications, shorter hospital stays, better outcome and increased patient satisfaction compared with conservative therapy. Copyright © 2007 Wiley Interface Ltd

Although the incidence of mumps orchitis has dramatically declined since the introduction of the childhood vaccination programme, a sharp increase in reported cases of both mumps and mumps orchitis has been seen recently in the UK. There are great concerns about mumps outbreaks and the associated risk of infertility; it remains an important clinical condition. Immunization is the best policy to avoid this viral disease.

Ann R Coll Surg Engl 2006; 88: 496-498 496Urethral dilatation has been advocated as empirical treatment for adult women with lower urinary tract complaints for long time. The discovery of a distal urethral ring by Lyon and associates led to the hypothesis that urethral stenosis was the cause of recurrent urinary tract infections (UTIs) and dysfunctional voiding in girls. 1 It was postulated that rupture of this ring by dilatation would relieve the obstruction. Kerr and associates decided on cutting this contraction ring with the otis urethrotome rather than dilating it with sounds.2 At the same time, they extended this procedure to include adult female patients.Although reviewing the literature reveals little solid evidence regarding the theoretical basis of this practice, several reports suggest that urologists are still practising urethral dilatation as treatment for a variety of complaints that are not efficiently managed by other means.To this end, we conducted a study to establish and report the results of an anonymous survey about urologists' practice patterns and attitudes towards the use of urethral dilatation in adult women with lower urinary tract complaints. Materials and MethodsAn 8-item questionnaire was mailed to 428 consultant urologists listed as full members of the British Association of Urological Surgeons. The questionnaire focused on assessing the relative indications of performing urethral dilatation by urologists, perceived effectiveness, frequency of using the procedure, the need for repeated dilatation, form of anaesthesia used and the maximum size of dilators to be used. Consultants were asked to state how long it was since they were appointed as consultant urologists. ResultsA total of 176 urologists completed and returned the questionnaire (response rate 42%), of which 171 returns were considered for evaluation (5 consultants reported that they never offer their patients dilatation). The results of the survey are listed in the Appendix.Although 12% of urologists believe urethral stenosis is the only indication for dilatation, it was the most common

This article discusses infective and malignant complications of HIV affecting the genitourinary tract in men. Immunosuppression increases both the frequency of infections, and the range of organisms that may be involved. Cancers are common and presentations may be atypical.

Fournier's gangrene is an uncommon but serious surgical emergency, usually occurring in association with diabetes, chronic alcoholism or immunosuppression. Surgical excision of devitalised tissue is essential to stop the spread of infection; even with modern supportive care, the mortality rate is still high. Copyright © 2007 Wiley Interface Ltd