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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 nurse specialist shortage: a view from the coal face

Prostate Cancer UK recently reported that there is an impending crisis for men with prostate cancer, simply because the number of nurse specialists available is insufficient for their needs [1]. Background As has been widely reported, the incidence of prostate...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

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...

Radiological appearances of renal vascular anatomical variants

The purpose of this article is to explain and illustrate common renal vascular variants that can be depicted with imaging. Renal vessels commonly present a wide range of variations [1]; before major renal or vascular surgery is undertaken, accurate portrayal...

Bouncing Back: support, mentorship and advice for those unsuccessful in urology ST3 national selection

The 2018 BAUS Annual Scientific Meeting in Liverpool delivered the first session for applicants unsuccessful in urology ST3 national selection. The session was organised and run by Luke Forster, Core Training Liaison Representative, along with several trainees. Background The concept...

Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...

Urethral pain syndrome – is there a light at the end of the tunnel?

Urethral pain syndrome (UPS) is defined in the 2014 EAU Guidelines as the occurrence of chronic or recurrent episodic pain perceived in the urethra, in the absence of proven infection or other obvious local pathology. UPS is often associated with...

Transplant urology at Guy’s Hospital: making the most of a year out before specialty training

It was gutting to miss out on urology at national selection on my first attempt. The ST3 application has become increasingly competitive and this means more appointable trainees find themselves looking to plan B. The options available can be daunting...

In conversation with James Green

We were delighted to catch up with James Green, Consultant Urological Surgeon and new President of the Royal Society of Medicine Section of Urology. Can you tell us a little bit about what led you into the field of urology...