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Practising surgery in a war zone: an interview with Dr Volodymyr Melnyk

It is now nine months since the full-scale Russian invasion of Ukraine commenced in late February 2022, with Putin announcing a “special military operation” to “denazify and demilitarise” Ukraine. The rest of the world, however, saw it for what it...

Sustainable healthcare: what steps can urologists take?

Human health is intrinsically linked to environmental health, making the ever-pressing climate crisis fundamentally a public health emergency. The healthcare sector is responsible for 8% of the UK’s greenhouse gas (GHG) emissions worldwide [1]. As the largest publicly funded healthcare...

Medical statistics for urologists: part 2 – probability and hypothesis testing

Following on from Part 1 of this series (Part 3 available here), this article aims to build on other analytical techniques commonly used within medical research, focusing on simple examples. Probability and testing Before exploring hypothesis testing, it is vital...

Clear cell urothelial carcinoma: a highly aggressive morphological variant in the bladder and upper urinary tract

Clear cell urothelial carcinoma (CCUC) is a rare morphological variant of transitional cell carcinoma (TCC). It can occur anywhere along the urothelial tract and is characterised histologically by high grade carcinoma with an abundance of clear, glycogen-rich cytoplasm [1]. Alternative...

Management of urological issues following genital gender affirmation surgery for individuals assigned female at birth

Gender incongruence arises when there is a mismatch between an individual’s gender identity and their sex assigned at birth. Genital gender affirmation surgery (GAS) is the final step of transition for transgender and non-binary individuals who experience gender incongruence. This...

Botulinum toxin – from the sausage poison to urology

Botulinum toxin is the first biological toxin to be licensed for use in treating human disease and since its first therapeutic use in the early 1980s for strabismus has become widely used in the fields of ophthalmology, cosmetic surgery, migraine...

Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

Recent developments in bladder cancer – MIBC

This article takes a look back over recent years at new innovations and developments relating to muscle-invasive bladder cancer (MIBC) specifically, and will also touch upon what the future may hold. This article is also written as a continuation of...

Frailty in urology – part 2

The first article in this series defined frailty and introduced the concept and importance of identifying patients living with frailty who undergo surgery, including those undergoing urological procedures. In the second part of this series we outline how to identify...

Emphysematous pyelonephritis: a review

Introduction Emphysematous pyelonephritis (EPN) is an acute, severe, necrotising, bacterial infection of the renal parenchyma and surrounding tissues, with gas in the renal parenchyma, collecting system or perinephric tissue. Although it is rare, it is potentially life threatening and early...

Metastatic spinal cord compression – a review

Introduction Metastatic spinal cord compression (MSCC) is an oncological emergency that, unless diagnosed early and treated appropriately, can lead to significant morbidity and mortality, including paralysis and bladder and bowel dysfunction. MSCC can be defined as spinal cord or cauda...