Stereotactic body radiotherapy for oligometastatic disease secondary to urological cancer

The concept of oligometastatic disease is controversial. The traditional model of cancer, which most of us learnt at medical school, is of a disease which starts confined to an organ, for example the prostate, where it can be cured with...

The emerging role of physician associates in urology

The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...

Physiotherapy first for pelvic floor dysfunction

Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...

An algorithm for the management of haemorrhagic cystitis

Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...

Reflections on 20 years as an Army Reserve doctor: live a life less ordinary

It seems a very short time ago that my predecessor recruited me into my regiment as a surgical senior house officer during a varicose vein operation in a cottage hospital in Stroud, informing me that I would be only the...

Prostate cancer survivorship: a new path for uro-oncology

Over two million people in England have a diagnosis of cancer [1]. Of this figure, over 250,000 have been diagnosed with prostate cancer [2]. However, during the next decade, a rapid increase in the number of new cancer diagnoses, as...

Guide to gaining approval for a clinical study

This article focuses on gaining approval for clinical research involving NHS patients, although the principles can be applied to other types of research. It can be quite a daunting process for the uninitiated applicant. Often it can be made less...

Bladder cancer – an overshadowed ‘volcano’

Bladder cancer has often been overshadowed by the limelight of prostate cancer. However, of all the urological cancers, bladder cancer is the only one which has shown a slight decline in age-standardised five-year survival rates over the last couple of...

What to expect when meeting a statistician

There are a growing number of statisticians working closely with medics from all specialties. They have different training but they are driven by the same goal: to perform high quality evidence-based clinical research [1,2]. In a perfect world we would...

Testicular microlithiasis

Introduction Testicular microlithiasis (TML) was originally described in 1970 in a healthy four-year-old boy [1] and the first paper regarding microlithiasis as an entity seen on ultrasound was published in 1987 [2]. Testicular microlithiasis is seen on ultrasound as small,...

An MA in medical education – is it for you?

I have recently completed a three-year MA in medical education at the University of Winchester, which has been an edifying experience. The following article may appeal to readers who are considering such a venture. I have been a consultant for...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...