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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...

Intravesical cytosine arabinoside + Mitomycin C for bladder cancer – is it beneficial?

Mitomycin C (MMC) is often used as an intravesical therapy for low / intermediate risk non-muscle invasive bladder cancer. This randomised controlled trial (RCT) was designed to assess the safety and efficacy of MMC + cytosine arabinoside (Ara-C). Ara-C was...

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...

Effect of DUA on surgical outcomes of HoLEP

Lower urinary tract symptoms (LUTS) become increasingly common in men as they age, with over 70–90% of men aged over 80 experiencing these issues. Detrusor underactivity (DUA) is characterised by a weakened bladder contraction, leading to prolonged or incomplete bladder...

An account of training and practice of urology in Nigeria

Nigeria is the most populous nation on the continent of Africa. Within the country, there are 33,303 general hospitals and 59 tertiary hospitals to serve a population of approximately 210 million people [1]. Specialty-based practice of urology is domiciled in...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...

Urology: a missed opportunity for medical students

For those of us lucky enough to have medical students attached to our teams at some time during their undergraduate training, the opportunity undoubtedly represents a refreshing chance to teach well-educated and enthusiastic clinicians at the very start of their...

Improving on the Rotterdam Prostate Cancer Risk Calculator

Following the PROMIS trial [1], many cancer centres in the UK are now offering pre-biopsy multiparametric MRI (mpMRI) for men suitable for radical treatment. The European Association of Urology for Prostate Cancer (PCa) guidelines recommend individual risk stratification before the...

The life of a urology trainee in Singapore

Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...

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...

An old resectoscope in a wooden case

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). In the last article I said I would write about a particular artefact...