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The final hurdle: the consultant interview

The consultant interview is undoubtedly the most important exam you’ll ever sit; but curiously even the best and most motivated trainee becomes somewhat fatalistic when approaching this, the most important of all hurdles. Gone are the days when deals were...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Balanitis xerotica obliterans

Balanitis xerotica obliterans (BXO) / lichen sclerosus of the male genitalia is a common cause of acquired phimosis, and was first described by Stuhmer in 1928 [1]. It is described in medical literature as a chronic inflammatory condition of unknown...

Burnout: an increasing problem in urology

“What we mean, man,” said Chuck forcefully, “is this: how can we care for patients if nobody cares for us?” – Samuel Shem, The House of God, 1978. Samuel Shem’s (Steven Bergman, MD) satirical novel The House of God, has...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...

Why bother? Metabolic screening for stone formers

Introduction Despite the considerable increase in the incidence of stone disease in the UK and elsewhere in recent years, urologists have engaged with preventative strategies to only a limited degree. With mounting evidence of the strong correlation between obesity and...

Urethral diverticulum: a review of the literature and local experience

Urethral diverticula are an uncommon finding on imaging. They are focal outpouchings of the urethra into the periurethral / urethrovaginal space, occurring more frequently in females (up to 6% of women) [1]. These diverticula are becoming more prevalent in clinical...

What’s in a name?

Kate Granger is a doctor and the founder of the #hellomynameis campaign; she is also a cancer patient. In this article she explains why she started the campaign, and why patient-centred care starts with an introduction. Chris and me the...

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]....

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...

Opening doors to difficult conversations: Communication tips from urology Clinical Nurse Specialists

Effective communication lies at the heart of specialist urological cancer care. For clinical nurse specialists and urology nurses, conversations often extend far beyond diagnosis and treatment, encompassing some of the most sensitive and life-changing discussions patients may ever face. Whether...

The surgical trainer – are we still evolving?

“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...