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Reflections on 20 years as an Army Reserve doctor: live a life less ordinary

It seems a very short time ago that my predecessor recruited me into my regiment as a surgical senior house officer during a varicose vein operation in a cottage hospital in Stroud, informing me that I would be only the...

Prostate cancer detection in younger men

Prostate cancer (PC) screening using prostate-specific antigen (PSA) testing with systematic biopsy (SBx) reduces mortality but risks overdiagnosis and unnecessary biopsies. Multiparametric MRI (mpMRI) enables MRI-targeted biopsy (TBx) of suspicious lesions and is now recommended before biopsy, although its role...

Erectile Dysfunction Part I: pathophysiology and risk factors

Introduction Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection, which is adequate for satisfactory sexual intercourse. The Massachusetts Male Ageing Study (MMAS) reported the results of a regional survey of men aged 40–69...

Consent Part 2

See Part 1 on this topic here Case 1 A 77 year old lady presents to the Emergency Department confused and generally unwell. She is septic and, on imaging, is found to have a 9mm obstructing right sided proximal ureteric...

Robotic assisted perineal prostatectomy: descriptive technique of the inaugural case in the UK

Robotic surgery has taken full flight in the USA since its start in 2000 [1] and is replacing procedures where open surgical techniques were solely employed. While this technology is met with criticism over the costs, the superiority of robotic...

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...

Suprapubic catheterisation – a core surgical trainee’s perspective

Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...

A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

First-of-its-kind international study launches to revolutionise quality of life for Black men with prostate cancer

BALANCE will generate pioneering evidence to fill gaps in our understanding of the challenges Black men face with prostate cancer and the support they need, making changes possible which will improve Black men's quality of life while navigating the disease....

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...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

What is new in lasers for endourology: looking into the future

From the first cystoscopic argon and neodymium-YAG (yttrium-aluminium-garnet) laser used for bladder tumours in 1976 by Staehler et al. [1], lasers have proven to be a versatile and an evolving tool in the therapeutic management of a variety of urological...