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Prolapse surgery with mesh: where do we stand in 2017? An ICS update

Background Surgery for pelvic organ prolapse (POP) is common among women. The lifetime risk of undergoing at least one surgical procedure for POP is up to 20% [1]. This kind of surgery will be increasingly important due to an ageing...

Stereotactic body radiotherapy for oligometastatic disease secondary to urological cancer

The concept of oligometastatic disease is controversial. The traditional model of cancer, which most of us learnt at medical school, is of a disease which starts confined to an organ, for example the prostate, where it can be cured with...

Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

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...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

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...

Onco-fertility: a review

Subfertility or infertility is a major problem affecting men diagnosed with testicular cancer (TC) either due to the disease itself [1], or as a result of management [2]. TC is the most prevalent cancer affecting men of reproductive age [3]....

Metabolic screening and stone-prevention in urolithiasis patients

The incidence and prevalence of kidney stones is increasing [1,2]. Significant recurrence rates are noted with 14% of patients experiencing a further episode at one year, 35% at five years, and 52% at 10 years [3]. Over 10% of stone...

Male infertility

Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...

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...

Penile cancer: a practical approach

Penile cancer is rare and accounts for less than 1% of all new cancer cases in males in the UK, with around 640 new cases diagnosed every year [1]. In England and Wales, the annual incidence is between 1.2 and...

Priapism

Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...