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Keeping your eye on the ball: atypical presentations of testicular malignancy

Most testicular cancers present with a painless lump on the testes, and most are confidently diagnosed on examination and ultrasound. They have an excellent prognosis, with 90% patients alive at 10 years [1]. However, advanced testicular cancer, or those with...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

Non-urothelial bladder malignancies

Case 1 An 80-year-old gentleman presented with a history of visible haematuria and recurrent urinary tract infections (UTIs). He has been performing intermittent self catheterisation (ISC) for detrusor underactivity for over 20 years. A flexible cystoscopy showed these appearances of...

Use of MRI in the evaluation of prostate cancer: part 1

Introduction Prostate cancer remains the most commonly diagnosed cancer in males and the second leading cause of cancer related deaths in UK men, after lung cancer [1]. The incidence of prostate cancer in the UK has shown a rapid increase...

An update on erectile dysfunction guidelines and treatment options

Erectile dysfunction is defined as the persistent inability to attain and / or maintain an erection sufficient for sexual performance. Not only does this have a psychosocial impact, it also affects the quality of life of both the patients and...

BCG strain differences have an impact on clinical outcome in bladder cancer immunotherapy

Bacillus Calmette-Guérin (BCG) has been part of the treatment algorithm for non-muscle invasive bladder cancer (NMIBC) for a number of years. In this single centre, prospective, randomised trial, two of the most commonly available strains, BCG Connaught and BCG Tice,...

Nephrocalcinosis

Case 1 What does this x-ray of the kidney, ureter and bladder (KUB) show? What are the likely causes? What is the pathology behind medullary sponge kidneys (MSK)? What is the risk of urolithiasis with MSK? How are such patients...

Curing pure CIS with radical surgery: lessons learned

As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...

Outcomes of sarcomatoid differentiation in urothelial carcinoma

Sarcomatoid differentiation is a rare variant of urothelial carcinoma (UC) seen in 0.6% of cases. Its response to neo-adjuvant chemotherapy (NAC) has not been well reported. The authors have done a retrospective analysis of patients undergoing cystectomy between 1995 and...

Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

What’s in a name?

Kate Granger is a doctor and the founder of the #hellomynameis campaign; she is also a cancer patient. In this article she explains why she started the campaign, and why patient-centred care starts with an introduction. Chris and me the...