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Ejaculatory dysfunction: a review of current practice and guidelines

Introduction The ejaculatory process is paramount to procreation in nature. It is a complex orchestration of physiology that results in emission of the ejaculate into the posterior urethra followed by ejection of those fluids from the urethra and orgasm. The...

‘No Deal’ Brexit – how might it impact urological practice in the UK?

On 29 March 2017, the Government of the United Kingdom of Great Britain & Northern Ireland triggered Article 50 of the Lisbon Treaty, formally starting the two-year period for talks with the European Union (EU) in which to reach a...

Bladder outlet obstruction

Case 1 Define the zonal anatomy of the prostate: A, B and C What is the significance of Zone A and Zone C? Clasify the types of lower urinary tract symptoms (LUTS) Which investigations should be routinely undertaken for a...

Supporting return to clinical practice

There are many reasons for a clinician to take time away from clinical practice. These include parental leave, research, a period of ill health, a career break, or the opportunity to spend time pursuing other interests. At any one time,...

The emerging role of physician associates in urology

The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...

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...

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...

Penile Mondor’s disease

Mondor’s disease is a rare, self-limiting entity characterised by subcutaneous chord like bands throughout the body. These bands arise due to phlebitis of the subcutaneous vessels. Penile Mondor’s disease (PMD) is an isolated superficial thrombophlebitis of the superficial dorsal vein...

Understanding Stauffer’s syndrome

Who was Stauffer and what is Stauffer’s syndrome? Maurice Stauffer (1915-1994) was a gastroenterologist at the Mayo Clinic in Rochester, United States, and in 1961 first characterised the non-metastatic, paraneoplastic effects of renal cell carcinoma (RCC) on liver size and...

Urine leak post partial nephrectomy: a case for lower tract before upper tract

Partial nephrectomy has become the standard of care in the management of small renal masses. It is a vital tool in maximising nephron preservation and oncological control for patients. It has been shown to produce equivalent oncological outcomes to radical...

Localised renal cancer

Case 1 A 56-year-old lady is referred to the urology clinic after the GP conducted an ultrasound abdomen for deranged liver function tests and found a renal lesion. She is otherwise fit and well. Figure 1. What is the sensitivity...

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...