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Malignant upper urinary tract obstruction: emergency presentations and long-term outcomes

Malignant upper urinary tract obstruction (MUUTO) is a frequent emergency urological referral, often necessitating kidney drainage to preserve renal function. However, many patients have advanced cancer with limited life expectancy, raising questions about intervention benefits. While percutaneous nephrostomy (PCN) or...

Importance of PSA variation – an analysis of PLCO trial data

This study looks specifically at the group of patients in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial (PLCO), to investigate variations in prostate specific antigen (PSA) level. They have specifically included only patients who...

A guide to percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...

Managing sustainability

Planetary health needs to be addressed at a societal level for any meaningful impact to occur. As the global director of sustainability for a law firm, Marion Palmer provides an overview of the responsibilities of corporate organisations for both a...

ICS updates on continence care: what’s hot in physiotherapy after 80 years?

Origins of pelvic floor physiotherapy Physiotherapy, and in particular pelvic floor muscle training (PFMT) is nowadays first-line management for pelvic floor dysfunction (PFD). PFMT is originally attributed to Dr Arthur Kegel, hence the term Kegel exercises. Indeed, he was the...

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...

Androgen insensitivity in patients with proximal hypospadias

A number of surgeons use preoperative androgen stimulation for a period of time prior to hypospadias surgery. The aim is to increase glans circumference, penile length and improve prepucial vascularisation pre-surgery. Data confirming the results of these aims is scarce....

Active surveillance for intermediate-risk prostate cancer

In this review, Klotz and Dall’Era summarise available data from the Toronto, UCSF, ERSPC, PASS and Royal Marsden active surveillance cohorts, looking specifically at outcomes of patients classed as intermediate risk. Cancer specific survival in men managed initially with active...

Cystolithotripsy using the holmium laser: evolving uses for the laser lithotrite

This small prospective study examined 20 patients who were undergoing laser cystolithotripsy for bladder stones. Laser lithotripsy was performed using either a 365 or 550µm holmium:YAG laser fibre with a power setting of 1.0J and a frequency of 10Hz. Stone...

Use of MRI in the evaluation of prostate cancer: part 1

Introduction Prostate cancer remains the most commonly diagnosed cancer in males and the second leading cause of cancer related deaths in UK men, after lung cancer [1]. The incidence of prostate cancer in the UK has shown a rapid increase...

Management of calyceal diverticular stones using ultramini PCNL

Calyceal diverticulae are congenital smooth-walled, non-secretory urothelium-lined cavities within the renal parenchyma that communicate with calyceal fornix through a diverticular neck. They were first described by Rayer in Traitements des maladies des reins [1]. Calculi occur in approximately 9.5% to...

Ejaculatory dysfunction: a review of current practice and guidelines

Introduction The ejaculatory process is paramount to procreation in nature. It is a complex orchestration of physiology that results in emission of the ejaculate into the posterior urethra followed by ejection of those fluids from the urethra and orgasm. The...