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The role of embolisation in urology

Case 1 An 86–year–old male presented with visible haematuria and suprapubic pain. He had a history of diabetes, heart failure, benign prostatic hypertrophy, aortic valve replacement, deep vein thrombosis (DVT) and atrial fibrillation (AF) and was anticoagulated on a non-VKA...

Prostate cancer series: diagnostics 1

- Click here for Part 2 - A 58-year-old male is referred to your rapid access prostate clinic with a prostate specific antigen (PSA) of 6.0ng/ml. He has no lower urinary tract symptoms (LUTS), past medical history (PMH), or family...

The final hurdle: the consultant interview

The consultant interview is undoubtedly the most important exam you’ll ever sit; but curiously even the best and most motivated trainee becomes somewhat fatalistic when approaching this, the most important of all hurdles. Gone are the days when deals were...

Consensus statements on PSA testing in asymptomatic men in the UK

In January 2016, the UK National Screening Committee once again recommended against a systematic population screening programme for prostate cancer due to the, as yet, insufficient evidence that the benefits of screening would outweigh the harm to the population as...

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...

Burnout: an increasing problem in urology

“What we mean, man,” said Chuck forcefully, “is this: how can we care for patients if nobody cares for us?” – Samuel Shem, The House of God, 1978. Samuel Shem’s (Steven Bergman, MD) satirical novel The House of God, has...

A report from the second laparoscopic urology workshop in Dakar, Senegal

Hôpital Général Idrissa Pouye (HOGIP), formerly Hôpital Général de Grand Yoff – HOGGY), in Dakar, Senegal, is one of the most well-regarded teaching hospitals in West Africa. It has over 300 beds, a urology team of six consultants and attracts...

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...

Post-orgasmic illness syndrome

Introduction Disorders of ejaculation are a rare and poorly understood subsection of male sexual dysfunction. A paucity of evidence has hindered advances in definitions, epidemiology, pathophysiology and management. The licensing of a specific medication for premature ejaculation signalled the research...

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...

Neuroendocrine bladder tumour

A 75-year-old male with a history of prostate adenocarcinoma (T3b/T4 N1 M1b, Gleason 4+3) on Zoladex® and enzalutamide, presented with visible haematuria. His prostate specific antigen (PSA) had decreased from 43.6ug/L in December 2022 to 0.02ug/L. He also had a...