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Why bother? Metabolic screening for stone formers

Introduction Despite the considerable increase in the incidence of stone disease in the UK and elsewhere in recent years, urologists have engaged with preventative strategies to only a limited degree. With mounting evidence of the strong correlation between obesity and...

Nocturia – the Cinderella of lower urinary tract symptoms

Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...

Prostate cancer nurse specialist shortage: a view from the coal face

Prostate Cancer UK recently reported that there is an impending crisis for men with prostate cancer, simply because the number of nurse specialists available is insufficient for their needs [1]. Background As has been widely reported, the incidence of prostate...

OCERT: a new multi-specialty project to standardise robotic surgical training

Since its introduction by Dr William Osler in 1890 to the Board of Trustees at John Hopkins Hospital [1], the Halstedian ‘See one, do one, teach one’ has represented a guideline for surgeons worldwide, both for open and laparoscopic surgery,...

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...

An inconvenient truth: reflections on the NHS

“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...

Systematic reviews and meta-analysis – a stepwise approach

As per Cochrane definition (2013), a systematic literature review (SR) attempts “to identify, appraise and synthesize all the empirical evidence that meets pre-specified eligibility criteria to answer a given research question” [1]. A meta-analysis (MA) is a statistical assessment of...

Balanitis xerotica obliterans

Balanitis xerotica obliterans (BXO) / lichen sclerosus of the male genitalia is a common cause of acquired phimosis, and was first described by Stuhmer in 1928 [1]. It is described in medical literature as a chronic inflammatory condition of unknown...

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...

Prostate cancer: Black men more likely to be diagnosed at later stages

Latest data shows Black men have higher rates of stage 3 or stage 4 prostate cancer diagnoses compared with white men. Black men diagnosed at a later stage in their 60s are 14% less likely to get NICE approved treatment...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...

Challenges of catheter associated urinary tract infection: is prevention better than cure?

Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...