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Stereotactic body radiotherapy for oligometastatic disease secondary to urological cancer

The concept of oligometastatic disease is controversial. The traditional model of cancer, which most of us learnt at medical school, is of a disease which starts confined to an organ, for example the prostate, where it can be cured with...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

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...

All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

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)...

Robotic Urology Fellowship at UCLH

In November 2014, approaching my final year of training (ST7) in the West of Scotland (WoS) and just recently armed with my FRCS (Urol), I was at a crossroad in my clinical career. I was keen to pursue a consultant...

Assessment of the incidental adrenal lesion

Introduction The adrenal glands are seen on CT or MRI surrounded by fat in the peri-renal space. The right adrenal gland lies medial to the right lobe of the liver, lateral to the right crus of the diaphragm and superior...

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...

Suprapubic catheterisation – a core surgical trainee’s perspective

Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...

Management of stage 1 non-seminomatous germ cell tumours

Testicular cancer (TC) is the most successfully treated solid tumour, achieving a cure rate of 90-95% [1-3]. Testicular cancer is relatively rare with an incidence of 2207 cases in the UK in 2014 [4] and yet is the most common...

Upper tract abnormalities

Case 1 Figure 1. A 26-year-old female presents to A&E with loin pain. What do the CT images in Figures 1 (left, centre and right) show? What is the prevalence of the congenital anomaly in the general population, and is...