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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...

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]....

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...

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...

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...

Delivering a trainee-led Urolink educational programme – my experience in Tanzania

In May 2023, I travelled to Moshi, Tanzania, where I visited Kilimanjaro Christian Medical Centre (KCMC) – a trip which was made possible through the collaborative efforts of the British Association of Urological Surgeons (BAUS) Urolink and with the support...

Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...