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Recent advances in the management of castration resistant prostate cancer

Castrate resistant prostate cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy lowering testosterone to castrate levels. It may present as a rise in serum levels of prostate specific antigen (PSA), progression of pre-existing disease, or the appearance of...

Which kidney to remove? – The urine separator

In this series of articles, I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk) this time helped by Hamza, one of our Leicester registrars who I recently...

Demanding cases or nightmares in endourology? Nov/Dec 2017

Case 1 A 78-year-old male was transferred from a referring hospital. He had a cystectomy and ileal conduit performed 15 years previously and had recently been admitted with a clinical diagnosis of an infected obstructed kidney. The referring hospital had...

Demanding cases or nightmares in endourology? May/Jun 2016

In the third article in this series the authors describe their experience with the very rare indications for laparoscopic stone surgery. Case 1 A 44-year-old woman presented with several months of malaise and right flank pain. A CT scan demonstrated...

Infections and inflammation: Part 1

See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...

Benign upper tract abnormalities

Case 1 A 28-year-old lady has been referred to your clinic with right loin pain. She has no significant past medical history but mentions that she and her partner have been trying to get pregnant. She has an US renal...

Urolithiasis 1 – ureteric colic

- Click for Part 2 and Part 3 on this topic - Case scenario A 45-year-old male presents to Accident & Emergency with two days of intermittent, severe, left-sided loin to groin pain and multiple episodes of vomiting. He undergoes...

Chronic retention – all you need to know

Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...

Consensus statements on PSA testing in asymptomatic men in the UK

In January 2016, the UK National Screening Committee once again recommended against a systematic population screening programme for prostate cancer due to the, as yet, insufficient evidence that the benefits of screening would outweigh the harm to the population as...

Ureterocystostomy – novel surgery for the paediatric obstructed megaureter

Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...

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...

Long-term oncologic outcomes of salvage cryoablation for rrPC

Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...