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Peno-scrotal extramammary Paget’s disease

Epidemiology Extramammary Paget’s disease (EMP) is a rare intraepithelial neoplasm, which is rarely invasive and has an incidence of six per million person-years as calculated by a European SEER analysis [1]. It usually affects apocrine gland-bearing areas, especially the vulvar,...

Erectile Dysfunction Part I: pathophysiology and risk factors

Introduction Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection, which is adequate for satisfactory sexual intercourse. The Massachusetts Male Ageing Study (MMAS) reported the results of a regional survey of men aged 40–69...

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...

Simple spit test could finally turn the tide on prostate cancer

Saliva test which analyses genetic variants in DNA is better than the PSA blood test at assessing prostate cancer risk for some men, and doesn’t require a visit to the GP. The test gave fewer false positive results and picked...

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...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

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...

Recent developments in bladder cancer – NMIBC

Every year, roughly 10,300 individuals are diagnosed with bladder cancer in the UK, making it the 11th most common cancer in the UK, and the eighth most common cancer in men [1]. Of those diagnosed with the disease, 75-85% will...

In conversation with Roger Kirby

We were delighted to catch up with Roger Kirby, new President of the RSM, about his illustrious career in urology. Can you tell us a little bit about what led you into the field of urology and what have been...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...