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Demanding cases or nightmares in uro-oncology? Sep/Oct 2022

Treatment of prostate cancer in renal transplant recipients is challenging due to a lack of knowledge of the natural history of cancer in these patients, the anatomical position of the graft in the iliac fossa and its proximity to the...

Technology – Part 2

Case 1 Name the machine shown in the picture and describe how it works. What is the standard frequency of ultrasound waves in this machine? What frequency of ultrasound waves are utilised in an abdominal and scrotal ultrasound? Case 2...

Demanding cases or nightmares in uro-oncology? Jan/Feb 2023

Radical surgical treatment of prostate cancer has become minimally invasive owing to robotic assisted laparoscopic technology [1]. Patients who undergo robotic assisted radical prostatectomy (RARP) often have lower risk of morbidity compared to an open approach. However, patients with a...

Image-guided renal cryoablation

Introduction There has undoubtedly been a dramatic increase in the number of patients diagnosed with small renal masses in recent years [1]. The rapidly expanding use of CT has led to a large number of incidental diagnoses, but increasing longevity...

Infections and inflammation: Part 1

See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...

Prostate cancer management 2 – metastatic disease

A 72-year-old gentleman is referred to you in the two-week wait clinic with a prostate specific antigen (PSA) of 22ug/L. He is otherwise fit and well and does not take any regular medication. His multi-parametric magnetic resonance imaging (mpMRI) shows...

Long-term complications of bulking agents in the treatment of SUI

Incontinence poses a substantial economic burden on the UK’s NHS, estimated at £536 million in 1999/2000, equivalent to approximately 1.1% of the total NHS spend, for both men and women. Over two decades later, this cost is expected to have...

AML – a rare variant

With the increasing number of CT and ultrasound scans performed in hospital practice more and more incidental angiomyolipomas (AML) are being picked up, some of which are asymptomatic and may not bother patients at all. This study comes from the...

Shared decision-making – minimising the mismatch

In Western countries, we are spoilt for choice in almost every aspect of our lives, but does that reflect also in healthcare? While we have taken some big strides towards shared decision-making with our patients, the age-old physician dominance remains...

Prostatic artery embolisation – an option for select BPO patients

Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...

Infections and inflammation: Part 3

See also Part 1 and Part 2 Case 1 You review a man in the Emergency Department with scrotal pain and sepsis. His clinical examination findings are shown. What does this image show? Who was this condition named after? What...

Understanding gender differences in nephrolithiasis

Rates of nephrolithiasis are higher in males than females. The cause for this remains unclear, however animal models have demonstrated an association between sex steroid hormone levels and lithogenesis. This relationship in humans is less well established. This study from...