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Urethral diverticulum: a review of the literature and local experience

Urethral diverticula are an uncommon finding on imaging. They are focal outpouchings of the urethra into the periurethral / urethrovaginal space, occurring more frequently in females (up to 6% of women) [1]. These diverticula are becoming more prevalent in clinical...

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...

Robot assisted laparoscopic prostatectomy versus open retropubic prostatectomy – complication and readmission rates

Readmission rates in postoperative patients are an important health economic and clinical challenge faced in the modern NHS, with financial levies attached. In America since 2013, hospitals have been faced with ‘readmission penalties’ deducted from Medicare reimbursements. This was the...

Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...

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...

Comparison of pathological stage in patients treated with and without neoadjuvant chemotherapy for high-risk UTUC

High-risk upper tract urothelial carcinoma (UTUC) has been associated with poor survival outcomes. The authors evaluated the role of neoadjuvant chemotherapy in high-risk cases prior to radical nephroureterectomy (RNU) in terms of pathological stage of the final surgical specimen. A...

Patients’ preferences for additional (cytoreductive) treatments to the prostate and metastasis in metastatic prostate cancer

Patients diagnosed with metastatic prostate cancer at first diagnosis or de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) have had reported increases in overall survival due to rapid advances and intensification of systemic therapy regimes beyond traditional androgen deprivation therapy...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

A viable alternative in prostate enucleation: PlasmaLEP

Lamidey Noury Medical is a French based factory with over 70 years of surgical expertise in electrosurgery. We proudly manufactured Plasma EDGE, a bipolar plasma resection system designed specifically for TURP and bladder tumour resection. We developed an innovative system...

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...

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...

The importance of active investigation and follow-up in bladder injury

Bladder injury (BI) is uncommon, and patients are typically managed by large multidisciplinary teams, dealing concomitantly with other injuries or diagnoses. BI can be categorised by cause (traumatic vs. iatrogenic) or anatomical location (intraperitoneal vs. extraperitoneal), requiring differing approaches to...