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What's known on the subject? and What does the study add? One of the main components of surgical training is the development of operative skills which, in part, is related to the extent of the practical operative experience. The operative experience of urological trainees in the UK has not being previously published. We examine trainees' current operative experience and analyse the changes over recent years. With a notable decrease in experience of certain procedures, we highlight the possible reasons and discuss the implications for future training. We have examined the operative experience of urological trainees in the UK over a 6-year period. Between 2004 and 2009, urological trainees submitting their operative logbooks to the Specialist Advisory Committee for the award of Certificate of Completion of Training were analysed. We recorded trainees' experience in eight operative procedures; transurethral resection of the prostate (TURP, including bipolar TURP), transurethral resection of bladder tumour (TURBT), radical nephrectomy (RN, open and laparoscopic), radical cystectomy (RC), radical prostatectomy (RP), percutaneous nephrolithotomy (PCNL) and ureteroscopy (flexible and rigid). In all, 251 logbooks were identified over the 6-year period. In 2008/2009, the mean (range) number of cases ‘performed’ and ‘supervised’ were as follows; TURP 189 (41–516), TURBT 190 (50–432), open RN 21 (2–78), RC 10 (0–70), RP 13 (0–80), PCNL 19 (0–125), ureteroscopy 131 (14–465), laparoscopic RN 11 (0–97). Latterly there has been a significant reduction in the numbers of TURP, open RNs and RCs. There has been an increase in the use of trainees as assistants for RC, RP and open RN. There was a large variation in numbers of procedures performed between trainees. In summary there has been a recent decline in the numbers of TURP, open RNs and RCs performed. For all procedures, significant variability exists between trainees.

OBJECTIVE To describe a 25-year experience of using the Whitaker test in a single tertiary centre for assessing upper urinary tract dilatation, and to evaluate the role of perfusion pressure-flow studies in contemporary urological surgery for equivocal upper tract obstruction. PATIENTS AND METHODS In all, 143 patients with suspected upper urinary tract obstruction were investigated by at least one Whitaker test. The original method was extended to include observations on high flow-rate perfusion, abnormal renal pelvic peristalsis and loin pain with no pressure increase. Data on clinical presentation, perfusion pressure-flow studies, diuresis renography and choice of initial therapy were collected prospectively, and the long-term clinical outcome was analysed retrospectively. RESULTS In total, 145 studies were assessed; the Whitaker test showed obstructive features at conventional or higher flow rates in 61 cases and unobstructive patterns in 53. There were four equivocal results. Seventeen studies showed abnormal peristalsis within the renal pelvis and in 10 there was 'sensory' loin pain during the test. In patients with idiopathic hydronephrosis, there was agreement between the results of the pressure-flow studies and diuresis renography in 72%. The Whitaker test determined or contributed to the clinical management in 84% of the cases studied. It was accurate in its prediction of outcome in 77% of cases where obstruction was diagnosed and in 77% of unobstructive cases. CONCLUSIONS The Whitaker test continues to have a role in modern urological surgery. It should be reserved for assessing potential upper urinary tract obstruction in the following circumstances: equivocal results from less invasive tests; suspected obstruction with poor kidney function; loin pain with a negative diuresis renogram; suspected intermittent obstruction; and gross dilatation with a positive diuresis renogram.

We present 2 cases of men that have inserted silicone seal-ant into their urethras. One man had ingeniously tried to use the silicone to remove a urethral foreign body he had inserted some months earl