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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...

Oncological Imaging: Urology

Imaging updates on renal tumours, urothelial tumours, prostate, adrenal and retroperitoneal tumours are all covered in this text. Whilst aspects relating to prostate imaging are probably covered better elsewhere, what remains is a decent account nicely contained within a single...

Childbirth Trauma

The appeal of this text will I suspect be limited to only a few from the urological fraternity – inevitably those with interests in uro-gynaecology and reconstructive surgery. The text deals with the basics of anorectal physiology as well as...

Refining management of non-visible haematuria

The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....

Urology: a missed opportunity for medical students

For those of us lucky enough to have medical students attached to our teams at some time during their undergraduate training, the opportunity undoubtedly represents a refreshing chance to teach well-educated and enthusiastic clinicians at the very start of their...

Technology – Part 1

Case 1 What is this and what material is it made from? What property of the catheter does the size refer to? What is the relationship between French size and diameter? What is a biofilm? How can you reduce catheter...

Help to handle increased volumes of urethral catheterisations safely

With urethral catheterisation volumes currently considerably increased, we are pleased to be able to announce that NHS Supply Chain is now listing the...

The scent of Ethiopia: a personal story – part 1

Background The year was 2004; I had just moved to the UK as a young house officer and finished my observership programme at Great Ormond Street Hospital in London. I was inspired by greats like Patrick Duffy and Phillip Ransley,...

Hard flaccid syndrome

Chronic pelvic pain is defined as pain present below the level of the umbilicus with a duration of more than six months [1,2]. Chronic pelvic pain syndromes (CPPS) are highly prevalent in Western society, affecting both males and females. Studies...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

Complications of CISC

Introduction Clean intermittent self catheterisation (CISC) was first introduced and popularised by Lapides in 1972. Since then its utilisation has become widespread and it is now commonly used throughout the world as the preferred means of facilitating complete and effective...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...