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Demanding cases or nightmares in endourology? Jan/Feb 2016
The second article in this series of challenging cases in endourology describes some stent-related problems. Case 1 A 76-year-old male with end stage renal failure due to obstructive uropathy from benign prostatic enlargement was transferred from a referring hospital. A...
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...
Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer
Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...
PSA screening in limbo: how low should we go?
One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...Online urology teaching
The COVID-19 crisis continues to disrupt our traditional models of teaching. Urological emergencies account for 20% of all acute surgical admissions and 5-10% of general practitioner visits [1]. Currently in the UK, undergraduate teaching on urology is not compulsory. Fewer...An overview of daytime wetting in children
It is estimated that daytime wetting affects one in seventy-five children over the age of five years [1]. Daytime wetting is commoner in younger children (1 in 7 aged 4.5 years, 1 in 20 aged 9.5 years) [1]. Many younger...
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...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...
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...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...
