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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...

What is a leadership fellowship?

What is a leadership fellowship?” This is a question that is often asked about my year out of training to undertake the National Medical Director’s (NMD) Clinical Fellow Scheme. I hope to provide an insight into what a fellowship in...

Burnout: is this just a pandemic phenomenon?

The phrase ‘burnout’ is often heard, but what is it, and what are the early warning signs? Importantly, how can it be prevented or managed? Over the last few years, health professional wellbeing, mental health, and burnout have come to...

A sigma six approach to improving nephrostomy and antegrade stent services at a district general hospital – an audit project

As hospitals merge into larger trusts there becomes a centralisation of some services. Interventional radiology (IR) has been one of those services. Our district general hospital runs bi-weekly lR lists following service centralisation. Urology and IR most commonly liaise on...

Ambulatory local anaesthetic implantation of percutaneous sacral nerve stimulators

Background The current treatment paradigm for detrusor overactivity (DO) and dysfunctional voiding (DV) includes conservative measures, pharmacotherapy, intravesical onabotulinum toxin A (Botox®), sacral nerve modulation (SNM / SNS) and urinary diversion as a last resort [1]. Incidence of DO is...

New drug hope for prostate cancer patients

• Hormone therapy is used to slow the progression of advanced prostate cancer, but cancers often develop resistance and continue to grow.• Research reveals that patients with higher levels of heat shock proteins have worse outcomes.• Targeting these proteins with...

The life of a urology trainee in Singapore

Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...

Consent: your obligations in the modern, post-Montgomery era

There has been so much recent discussion and so much emphasis placed on the fundamental right that we all have to determine what is or is not done to us, the right to self-determination, that it would be either a...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

‘One team’: our experience teaching catheter care and difficult urethral catheterisation to NHS Nightingale Hospital London volunteer staff members

The NHS Nightingale Hospital London was launched in response to the COVID-19 pandemic. In mid-March 2020, the predicted scale of the pandemic was uncertain and there was concern that COVID-19 might overwhelm existing intensive care unit (ICU) capacity within weeks....

Clear cell urothelial carcinoma: a highly aggressive morphological variant in the bladder and upper urinary tract

Clear cell urothelial carcinoma (CCUC) is a rare morphological variant of transitional cell carcinoma (TCC). It can occur anywhere along the urothelial tract and is characterised histologically by high grade carcinoma with an abundance of clear, glycogen-rich cytoplasm [1]. Alternative...

Urolink: past, present, future

The mission of Urolink, a sub-committee of the British Association of Urological Surgeons (BAUS) since 1996, has been: “To promote and encourage the provision of appropriate urological expertise and education worldwide, with particular emphasis on the materially disadvantaged.” The importance...