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Meeting in the middle: a review of the rendezvous technique to treat impassable ureteric strictures and transected ureters

Introduction Complex ureteric strictures present a significant challenge with some patients undergoing multiple separate urological and radiological procedures to try to cross a stricture without success. Cross-departmental collaboration with uroradiology may allow a decrease in the number of separate interventions....

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Defining adjuvant, consolidative, and salvage treatment after RP

The most common oncologic outcome following radical prostatectomy (RP) for localised prostate cancer is achieving undetectable prostate-specific antigen (PSA) levels (<0.1 ng/ml), indicating an absence of detectable disease. However, the landscape of RP is shifting as active surveillance becomes the...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

Management of Prostate Cancer: A Multidisciplinary Approach

This is an excellent textbook which comprehensively covers the vast field of prostate cancer. The editors, who have co-ordinated phase III European Organisation for Research and Treatment of Cancer (EORTC) trials, have brought together a large array of well-known international...

Burnout – a personal story

My name is Michael, and I am a urology ST5 registrar based in the West Midlands. Growing up in a Far East Asian household, I watched my father, a gynaecologist, and my mother, a parasitologist, devote countless hours to their...

Post CCT fellowship in genitourethral reconstruction at St George’s Hospital: an experience unique to the UK

I first developed an interest in genitourethral reconstruction, particularly urethroplasty, at the beginning of my urology training. Working in Bristol and Weston Super Mare for David Dickerson inspired me to develop this further. Mr Dickerson performs one of the largest...

Urinary incontinence in women – part 2: management

In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...

Upper tract abnormalities

Case 1 Figure 1. A 26-year-old female presents to A&E with loin pain. What do the CT images in Figures 1 (left, centre and right) show? What is the prevalence of the congenital anomaly in the general population, and is...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

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),...

Scalpels and stunts: reflections from an academic trainee and international-level athlete

When people find out I’m a urology registrar, they usually nod politely or giggle for obvious reasons. When they find out I’m also a competitive cheerleader, they tend to blink, pause, and then ask: “Wait, like pom-poms and high kicks?”...