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Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Imaging and surveillance in sporadic renal angiomyolipoma: how and when to monitor effectively

Renal angiomyolipoma (AML) are benign tumours, accounting for approximately 2–3% of all renal neoplasms [1]. Seventy percent of renal AMLs are sporadic, and 20–30% are associated with genetic aetiology. They are composed of smooth muscle, blood vessels, and adipose tissue....

Radiological appearances of non-vascular renal anatomical variants

Anatomical variants of the renal tract are common and, although often asymptomatic, may present with complications. It is essential to identify anatomical variants, as this may have an impact upon surgical planning and management. This article aims to demonstrate radiological...

Frailty in urology – part 1

Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...

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,...

Bladder carcinoma MRI

Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...

Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

COVID-19 and acute kidney injury

Newspapers and online media are full of the effects of the coronavirus on airways and olfactory functions and the importance of respiratory physicians (pulmonologists in the USA), ventilators and intensive care teams. However, as per the Intensive Care National Audit...

Penile cancer: a practical approach

Penile cancer is rare and accounts for less than 1% of all new cancer cases in males in the UK, with around 640 new cases diagnosed every year [1]. In England and Wales, the annual incidence is between 1.2 and...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

Things I wish I knew before starting on-call as an CST in urology

When I started my first core surgical trainee (CST) job in urology, I had no prior exposure or experience. Quickly I realised the significant step up and responsibility involved. Covering multiple sites overnight is something that requires organisation and awareness...