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Importance of PSA variation – an analysis of PLCO trial data

This study looks specifically at the group of patients in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening trial (PLCO), to investigate variations in prostate specific antigen (PSA) level. They have specifically included only patients who...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Artificial penile pearls: what every Urologist should know!

Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...

Essential Revision Notes for the FRCS (Urol) Books 1 & 2

In the past a Professor of Urology was frequently quoted as saying “the curriculum for urology is urology”. Indeed that it is, but that definition did not give trainees at the time the much needed framework for navigating through a...

The importance of active investigation and follow-up in bladder injury

Bladder injury (BI) is uncommon, and patients are typically managed by large multidisciplinary teams, dealing concomitantly with other injuries or diagnoses. BI can be categorised by cause (traumatic vs. iatrogenic) or anatomical location (intraperitoneal vs. extraperitoneal), requiring differing approaches to...

A guided guide to the guide wire

The use of guide wires has become a core skill utilised by urologists, especially within the field of endourology. The authors take us through the development of the guide wire and their current use in urology. The history The first...

Percutaneous nephrolithotomy: wisdom, dogma, paradigm and myths

A non-transpapillary technique appears to ease access to the kidney – the most critical step in percutaneous nephrolithotomy (PNL) – when compared to the classic transpapillary approach. Remarkably, the earliest descriptions of percutaneous access by Goodwin et al. in 1955...

Can you boost your bladder with vitamin D?

Bladder overactivity is a common problem affecting the social functioning of children. Overactive bladder dry (OAB-dry) is a term (one not utilised by the International Children’s Continence Society) and refers to patients who are experiencing frequency, urgency and nocturia symptoms...

Can we make LATE-presenting posterior urethral valves an EARLIER-treated condition?

What are posterior urethral valves? Posterior urethral valve (PUV) is the most common cause of congenital bladder outlet obstruction (BOO) and renal failure in male children. They were first described by the Italian anatomist Giovanni Battista Morgagni back in the...

LUTS update

Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...

A practical guide to success in National Selection

Gidon Ellis and Jonathan Makanjuola were both selected at National Selection in 2012 for Urological Higher Surgical Training. Both were ranked first in their respective interview rounds that year. It is no mean feat. Having read their article – their...