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Men with a susceptibility to prostate cancer: implications of ethnicity in PCa risk-prediction and diagnosis

The diagnostic and therapeutic landscapes of prostate cancer (PCa) have advanced at great pace in the past decade. However, disparities in access to care, clinical outcomes and representation in therapeutic, interventional and genomic studies continue to exist between Afro-Caribbean (AC)...

The bulbocavernosus reflex

Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...

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...

Artificial intelligence

Artificial intelligence concerns me. Generally, people still tend to be concerned that their livelihoods will be replaced by an all powerful, all knowing artificial intelligence (AI) system. This at a time when the world’s largest technology companies (Amazon, Google, Apple),...

Female and functional

Case 1 A 65-year-old woman presents with an 18-month history of “recurrent urinary tract infections” (rUTI). She is otherwise fit and well with no underlying medical problems and no lower urinary tract symptoms. What is the definition of a UTI...

A ‘survival guide’ to an ST3 year in urology

Following success in national selection, it soon dawns on the successful candidate that entry into higher surgical training (HST) requires more than a little clinical knowledge. The role requires administrative and organisational skills not hitherto called upon. This additional skill...

Partial segmental thrombosis of the corpus cavernosum

Epidemiology Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare condition and usually presents in young men. Approximately 56 cases have been reported in 34 publications since 1976, when the first two cases were described [1,2]. The mean...

Laparoscopic transposition of renal lower pole crossing vessels

The vascular hitch procedure for pelvi-ureteric junction obstruction (PUJO) was initially described by Hellstroem in1951 and has become popular again since the introduction of laparoscopy. There is still much controversy as to its efficiency. The authors of this paper analyse...

Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

An Illustrated Guide to Pediatric Urology

This new illustrated guide (published 2017) provides a comprehensive coverage of the field of paediatric urology. There are 31 chapters. Written in bullet point form, it contains a wealth of information for urologists, specialty trainees and others (e.g. urological nurses)....

To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy

The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...