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MRI screening for prostate cancer: a step towards a ‘prostagram’

The UK National Screening Committee has been calling for further research into alternative screening tests for prostate cancer. The committee decided against prostate cancer screening using prostate specific antigen (PSA) testing on the basis that “PSA is still a poor...

Testicular cancer (Jan 2016)

Case 1 A 26-year-old male presented with a two-week history of testicular pain and swelling. On examination the right testicle was enlarged, indurated and tender. Erythema of the scrotum on that side was also noted. Ultrasound of the testis reported...

Prostate cancer series: diagnostics 2

- Click here for Part 1 - A 68-year-old male was referred to the two-week wait prostatic clinic with a serum prostate specific antigen (PSA) of 17. He had no bothersome lower urinary tract symptoms, relevant past medical history or...

Innovations in urology – OOPE for trainees

“Innovation is the ability to see change as an opportunity – not a threat” – Steve Jobs [1] The world is changing rapidly. Healthcare has seen a fast reform, especially as a consequence of COVID-19. Urology is a rapidly evolving...

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...

Prostate cancer survivorship: a new path for uro-oncology

Over two million people in England have a diagnosis of cancer [1]. Of this figure, over 250,000 have been diagnosed with prostate cancer [2]. However, during the next decade, a rapid increase in the number of new cancer diagnoses, as...

What to expect when meeting a statistician

There are a growing number of statisticians working closely with medics from all specialties. They have different training but they are driven by the same goal: to perform high quality evidence-based clinical research [1,2]. In a perfect world we would...

Focal therapies in prostate cancer

The standard of care in the management of prostate cancer has, to date, always been to treat the whole gland. This has ranged from surveillance, surgical excision / prostatectomy or external beam radiotherapy / whole gland brachytherapy. With the evolution...

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...

Intravesical glycosaminoglycan analogue instillations for recurrent cystitis

Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

Pelvic floor imaging – a brief synopsis

Background Pelvic floor imaging is an important part of both gastrointestinal and functional urology / urogynaecological departments. Symptoms such as obstructive defecation, incontinence and sphincter complex disorders have a significant impact on patient lifestyle and physical / mental well-being [1,2]....