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Adrenal incidentalomas: what next?

An incidentaloma refers to an adrenal lesion >1cm discovered incidentally during radiologic examination. Identifying a malignant and / or functioning lesion is critical for management. However, as the majority of lesions are benign, the challenge is the identification of malignant...

Prostate Cancer – Diagnosis and Clinical Management

This rather modest looking paperback actually punches well beyond its humble appearance. There are of course the predictable sub-sections appropriate to any prostate cancer text – but that said this relatively small-volume affair (compared to some of the Goliaths out...

In conversation with Mary Garthwaite

We were delighted to chat with Mary Garthwaite, former Consultant Urological Surgeon and Chair of The Urology Foundation, the UK’s only charity representing all urological cancers and conditions. Can you tell us a little bit about what led you into...

Virtual reality: a novel approach to pain management during ESWL

Extracorporeal shock wave lithotripsy (ESWL) is a well-established treatment for kidney and ureteric stone disease, employing high-energy shock waves to fragment stones into smaller pieces for passage through the urinary tract. This article explores the application of virtual reality (VR)...

Accuracy of cognitive vs software-guided MRI-targeted biopsy

The FUTURE randomised trial showed no difference in prostate cancer (PCa) detection between cognitive, in-bore and software guided MRI-targeted biopsy (TBx) techniques, a finding supported by meta-analyses and reflected in European Association of Urology (EAU) guidelines. However, whether any TBx...

Training to be a urologist: how risky is it?

The NHS and urology face challenging times in trying to provide quality patient care efficiently and economically. Urology trainees are experiencing conflicting pressures with a new contract, a challenging on-call system and changing training requirements in an overstretched, centralised service...

Demanding cases or nightmares in uro-oncology? Sep/Oct 2021

Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...

PUJO: Hellstrom principle revisited

This paper describes the result of four out of twenty-three cases (two males, two females) of pelvi-ureteric junction obstruction - PUJO - (mean age 18.25 years, range 16-20), mean follow-up two years (range six months – three years) that were...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

Klinefelter’s syndrome

Klinefelter’s syndrome (KF) is the most frequent sex chromosome abnormality with an estimated prevalence of 1 in 500 to 1 in 700 newborn males and 1 in 10 in men with azoospermia. While the majority of cases are an XXY...

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...

Cryotherapy for small renal masses: better than surveillance?

With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...