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Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer
Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...Priapism in sickle cell disease
What is sickle cell disease? Sickle cell disease (SCD) is one of the most common single-gene disorders in the UK affecting approximately one in every 2000 live births. Approximately 20-25 million people worldwide have SCD. It predominately affects those of...Recent developments in bladder cancer – MIBC
This article takes a look back over recent years at new innovations and developments relating to muscle-invasive bladder cancer (MIBC) specifically, and will also touch upon what the future may hold. This article is also written as a continuation of...
PFMT in males
Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...A guide to local anaesthetic transperineal prostate biopsy
In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...
Button vesicostomy
Poor bladder emptying often requires clean intermittent catheterisation (CIC). In significant numbers of children CIC is not possible for a variety of reasons and an alternative is needed. This paper reviews a single centre’s usage of the vesicostomy button over...Challenges in urology during and after the COVID-19 pandemic: a trainee perspective
The COVID-19 pandemic has affected urological practice in many ways and at all levels. Social media has been set alight with the hashtag #NoTrainingTodayNoSurgeonsTomorrow highlighting the undesired consequences of the reduction in training opportunities. The impact has been considered by...Lifestyle interventions for UI in women
Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...Genital gender affirmation surgery for transgender men
Genital gender affirmation surgery (GAS) is the final step in the transition journey for transgender men. Genital GAS involves a combination of procedures to surgically align physical characteristics with one’s gender identity. These needs change between each individual depending on...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...
Abiraterone acetate in men with castration-resistant prostate cancer
With emerging results from the Stampede and Latitude studies, abiraterone has taken the forefront in the management of metastatic prostate cancer while researchers try to identify the ideal timing for administration. It is a potent inhibitor of CYP17 which results...
