Johnston Canyon, Banff, Canada
Johnston Canyon, Banff

For Clinicians · Learning Hub

Learning Hub

A guide for residents and students — what to read, and in what order.

The 16 clinical articles, regrouped into a reading order. Each entry carries its level, its length, and the sections it contains. To go straight to a term, use the search above — it searches the full text, not just titles.

Foundational concepts, development, pathogenesis and natural history Advanced operative choice and interpreting outcomes

Hypospadias

Start from what we are trying to correct; take in why the three findings travel together and why it arises at all; read curvature as structure and see in what order it is straightened; then move to severity and outcome.

  1. 1
    Hypospadias, Part 1 — What Are We Aiming At?

    Foundational6min

    Three problems, three requirements · Why curvature sits at the centre · Which makes the first operation's judgement heavy · What this series will cover

  2. 2
    Hypospadias, Part 4 — How the Urethra Is Built

    Foundational6min

    The shaft urethra is built in two steps · The glans is built by a different mechanism · Why the prepuce goes wrong with it · In the next instalment

  3. 3
    Hypospadias, Part 5 — Is It Really Increasing, and Why Does It Happen?

    Foundational10min

    Is it really increasing? · What has been named as a cause · So what do we tell the parent? · In the next instalment

  4. 4
    Hypospadias, Part 6 — Why the Penis Curves

    Foundational13min

    What the names tell us, and what they do not · What is holding it down — separating the contributing components · How the explanations and the surgical strategies widened · The name corporal disproportion

  5. 5
    Hypospadias, Part 7 — How Much Curvature to Correct, and in What Order

    Foundational12min

    From what angle do we correct? · Measuring — artificial erection and the angle · Release, re-measure — the stepwise flow · Shorten or lengthen? · Cutting the bowstring does not straighten the bow · When the penis bends again · Straight penis first

  6. 6
    Hypospadias, Part 3 — "Is My Son’s Case Severe?" Matching Severity

    Advanced6min

    Meatal position does not determine severity · What the GMS score actually tells us · The limits of the GMS score · But the GMS score is only half an answer · What remains — on what basis does a parent choose a surgeon? · Next

  7. 7
    Hypospadias, Part 2 — What Counts as a Good Result?

    Advanced8min

    Several instruments already exist · The same result scores differently depending on who is looking · The functional side is emptier still · Implications for counselling

Vesicoureteral reflux

Establish why reflux occurs and why renal damage takes two routes; look at the natural history of reflux; then follow how infection leaves a scar and how the remaining kidney fares over the long term.

  1. 1
    Vesicoureteral Reflux, Part 1 — Why it happens, and why the kidney suffers

    Foundational12min

    First, primary and secondary · A kidney requires a meeting · How the orifice finds its place · When the bud arises off-target · Why the tunnel matters — and is 5:1 a law? · A different route to the same failure — the paraureteral diverticulum · Why the kidney suffers — two routes · How far genetics has got · What I take from this

  2. 2
    Vesicoureteral Reflux, Part 2 — Will it resolve, and is it safe to wait?

    Foundational8min

    Resolution is not the crossing of a single number · Resolution rates by grade · How solid is that grade? · The ureteral diameter ratio · Which variable predicts what · Observation is a plan

  3. 3
    Vesicoureteral Reflux, Part 3 — How pyelonephritis leaves a scar on the kidney

    Foundational10min

    Between a bladder infection and an infection of the renal parenchyma · Papillary shape changes intrarenal reflux · The response that clears bacteria and the response that injures tissue · Why a scar remains after the infection is over · When to assess what the kidney is left with · What changes with one more infection

  4. 4
    Vesicoureteral Reflux, Part 4 — How a small or scarred kidney grows

    Foundational10min

    The same reflux, different starting kidneys · A small kidney does not necessarily keep getting worse · In some, function declines even without infection · Loss on one side and loss of total function are different things · Reading the lesion on imaging alongside the change happening now · There is still work to do after the reflux has resolved

Undescended testis

Establish the mechanism of descent and the prognosis first, then the choice of operation by position.

  1. 1
    Undescended Testis, Part 1 — The Shifting View of Pathogenesis and Prognosis

    Foundational5min

    A Historical Look at Pathogenesis — From Hormonal Theory to Structural Theory · Prognosis — Unilateral vs. Bilateral, by Paternity Rate

  2. 2
    Undescended Testis, Part 2 — Surgical Treatment Choices by Position and Situation

    Advanced5min

    Approach Selection — Scrotal vs. Inguinal · When Is Laparoscopy Indicated? · Single-Stage vs. Two-Stage Surgery — How Atrophy Rates Changed Over Time · Is Diagnostic Laparoscopy Necessary? · The Shehata Technique — A Complementary Alternative

  3. 3
    Undescended Testis, Part 3 — Two-Stage Surgery for the Intra-abdominal Testis: Does Preserving the Gubernaculum Reduce Atrophy?

    Advanced12min

    Blood supply of the testis — arteries and veins · What remains after the testicular vessels are ligated · Where the second stage diverges · How the testis comes down with the gubernaculum preserved · How far the evidence goes · Where to use it — the author's view · Open questions

Concealed penis

Sort out why the terminology never converged, then move to indications, timing and technique.

  1. 1
    Concealed Penis, Part 1 — Terminology, Aetiology, Classification, and Penile Size

    Foundational7min

    Terminology — why it never converged · Aetiology — observations that contradict each other · The overlooked axis — ratio, not fat · Classification — a history of attempts

  2. 2
    Concealed Penis, Part 2 — Indications, Timing, and Technique

    Advanced10min

    Indications — what the guidelines do not say · Timing — a debate without consensus · Technique — common principles and their limits · How the technique came to change · Should circumcision be performed? · What remains

For medical professionals

This section contains academic material for medical students, residents, and clinicians — including surgical detail and technical terminology. Continue?