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SMILE: sustaining medical education in a lockdown environment

2020 posed challenges to medical education like never seen before. In an effort to contain and slow the spread of coronavirus all UK medical schools ceased or reduced face-to-face contact. This sudden, and for many, unexpected change resulted in pressures...

Adults are just big kids: a paediatric surgeon’s experience in adult urology

As an ST8 trainee in paediatric general surgery and urology, I had firmly decided on subspecialisation in paediatric urology. Whilst preparing for the dreaded final Annual Review of Competency Progression (ARCP), the all-important question of “What next?” came to the...

Giggle incontinence – not a laughing matter!

For many decades, the condition of giggle incontinence (enuresis risoria, giggle micturition) has remained a rare and poorly understood condition. Patients (90% female) present in their teens, with the history revealing an issue for many years. It is debilitating and...

New drug hope for prostate cancer patients

• Hormone therapy is used to slow the progression of advanced prostate cancer, but cancers often develop resistance and continue to grow.• Research reveals that patients with higher levels of heat shock proteins have worse outcomes.• Targeting these proteins with...

(Not very) clean intermittent self catheterisation

In a small room near the operating theatre of the London Hospital sometime in the 1880’s, a surgeon slips off his outdoor frock coat. From his pocket he pulls a silver curved catheter, spits on it and nonchalantly passes it...

Endoscopic management of upper tract urothelial carcinoma

Upper tract urothelial carcinoma (UTUC) is a rare disease accounting for 5-10% of all urothelial carcinomas and has an annual incidence in Western countries of 1-2 per 100,000 [1,2]. It occurs more commonly in the pelvicalyceal system as opposed to...

Penile cancer: a practical approach

Penile cancer is rare and accounts for less than 1% of all new cancer cases in males in the UK, with around 640 new cases diagnosed every year [1]. In England and Wales, the annual incidence is between 1.2 and...

A guide to percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...

Demanding cases or nightmares in uro-oncology? May/Jun 2022

Delayed diagnosis of testicular cancer Testicular cancer is considered rare in the general population but is the most common cancer affecting males between 24 and 49 years. The diagnosis of testicular cancer depends on physical examination, ultrasound findings and tumour...

Upper tract abnormalities

Case 1 Figure 1. A 26-year-old female presents to A&E with loin pain. What do the CT images in Figures 1 (left, centre and right) show? What is the prevalence of the congenital anomaly in the general population, and is...

Preparing for the FRCS (Urol) viva

Ping! You look down to your phone and you have just received an email saying, “Congratulations, you have now successfully completed The Joint Committee on Intercollegiate Examinations section 1 of the Fellowship of the Royal College of Surgeons (Urol) exam.”...

The surgical trainer – are we still evolving?

“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...