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What’s new in post prostatectomy incontinence?

With an ageing population, the number of men being diagnosed with prostate cancer each year is steadily rising. With more specific investigations, such as multiparametric magnetic resonance imaging (MpMRI) and transperineal biopsies, the number of cases diagnosed at an earlier...

First and second-line treatments in metastatic renal cell carcinoma

Over the past two decades, the treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly, leading to a quadrupling of patient survival rates. Modern systemic treatments include combinations of anti-PD-1 antibodies with either anti-CTLA-4 antibodies or antiangiogenic tyrosine...

The surgical trainer – are we still evolving?

“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...

Simulation-based training of procedural skills: application and integration of educational theories

Educational theories: how familiar are we with these theories and their application in our training? As a Simulation Fellow I have been involved in teaching specific procedural skills and running full immersion simulation sessions. This experience has exposed me to...

Testicular tumour imaging

Testicular tumours are the most common tumour in young males with a peak incidence seen between 25 and 34 years [1]. The overall incidence is slowly increasing, although the exact reasons for this are uncertain, and there is a greater...

SMILE: sustaining medical education in a lockdown environment

2020 posed challenges to medical education like never seen before. In an effort to contain and slow the spread of coronavirus all UK medical schools ceased or reduced face-to-face contact. This sudden, and for many, unexpected change resulted in pressures...

Clinical visit for PCNL experience: Agra, India

In September 2015, I travelled to India for a two-week clinical visit with Professor Madhu Sudan Agrawal at the Global Rainbow Hospital, Agra. Having completed my training I wanted to further develop my skills with PCNL, particularly with regards to...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

Antimuscarinics and behaviour in patients with spinal dysraphism

Since the 1980s patients with spinal dysraphism have had aggressive bladder management with clean intermittent catheterisation and anticholinergic therapy from early on in life. This strategy aims at improving lower and therefore upper urinary tract function thus decreasing the risk...

NICE backs laser for BPH

Benign prostatic hyperplasia affects 60% of men aged 60 or over. The medical technology division of the National Institute for Health & Care Excellence (NICE) has supported the GreenLight XPS laser system as a surgical tool. The specific indications are:...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Urinary diversion and infections

This article will be of interest to colleagues undertaking reconstructive surgery. Urinary diversions have been performed for decades. Common indications are muscle-invasive bladder cancer, neurological disorders, inflammatory conditions and congenital malformation. The diversions could be continent or non-continent. Complications due...