Introduction: Hyperbaric oxygen therapy (HBO) is emerging as an alternative technique for treating refractory interstitial cystitis (IC). The theory is that the increased dissolved oxygen in the blood raises the levels of oxygen in the tissues and improves tissue healing. Other urological disorders such as radiation cystitis, Fournier’s gangrene and cyclophosphamide cystitis have also shown a good response to HBO therapy. Method: A literature search with the terms “interstitial cystitis”, “painful bladder syndrome” and “hyperbaric oxygen therapy” found four papers that have trialed HBO therapy in IC patients; three case series and one randomized control trial. Results: A total of 31 patients have been treated with HBO therapy. All four studies show a symptomatic improvement in pain, urgency, bladder capacity and O’Leary-Sant interstitial cystitis index. Urinary frequency only improved in three out of four of the trials. The percentage of patients considered as responders to treatment varied at 25%, 66.7%, 82% and 100%. Conclusion: Preliminary trials of HBO therapy seem to have a good patient response with effective symptomatic relief. The patient response rates varied greatly between the trials. This is due to each trial’s different definition of a “patient responder”. Further work in urology departments at HBO centers is required to further assess the benefits of HBO treatment in IC.

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The training of junior doctors in the UK is undergoing an evolution to ensure that those concerned are adequately trained and specialised for current and future consultant practice.The implementation of this training evolution is currently widespread at the foundation level (SHO-equivalent) and will expand to specialty training programmes as foundation programme trainees complete their training in 2007. Urology has led the change to the specialty training, with three-year trainees having entered the specialty in 2005. The emergence of urology as the lead specialty for change originated in part from a meeting in 1998 that addressed the future of urology and training, the summary of which was published later that year. The urology consultant workload is undoubtedly changing with the expansion of diagnostic services and the decrease in surgical in favour of medical treatments. The proportion of patients currently referred for surgery after an outpatient consultation has decreased and trainees are exposed to 50% of the operative experience of a decade ago.

Objective:To investigate the possible characteristics and patterns in the types of individuals who are likely to abscond from the urology clinic and the implications of these on the eventual outcome of the patient. Methods:Patients scheduled to be seen in urology clinic between the periods of January 2013 and June 2014 were logged into a database and followed up prospectively. Abscondees in this survey were defined as those patients who missed at least two clinic appointments without a valid explanation and/or those who simply could not be contacted for at least two weeks following the missed appointment. Demographics of patients were collected together with the mode of re-presentation, eventual outcome and reason for absconding. Results: A total of 1,207 patients records were interrogated. 17 patients were identified as abscondees. The combination of young male, renal calculus disease and absence of symptoms during time of absconding was present in approximately 82% of patients. Those citing no pain as a reason accounted for 16 patients [94%].100% of abscondees stated that they would have attended clinic if they had known the dangers of absconding. Conclusion:In urology patients, the risk of serious illness is significant in those who are lost to follow-up.Abscondees in this study were young males with stone disease. The perceived "benign" nature of the disease and the absence of renal colic gives the false impression that missing the appointment is unlikely to be detrimental. A greater emphasis patient education at first consultation is needed.