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Demanding cases or nightmares in endourology? Sep/Oct 2015

One of the most interesting aspects of attending international meetings is the rare but invaluable, honest presentation of complex cases. We aim to present the readers with some complex and challenging ongoing cases in endourology. Case 1 A general practitioner...

Clinical trials 1

Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

Urethral sphincter function before and after radical prostatectomy

This paper from Holland will be useful for urologists involved in radical prostatectomy (RP) for cancer of the prostate. It presents a PubMed search between 1980 and 2012. Twenty-five out of 124 articles were further analysed, mainly English-language papers. Several...

Functional and reconstructive urology

Case 1 A 45-year-old female presents with a one-year history of urinary leakage, especially worse on coughing. She is otherwise well, with no co-morbidities. What is the International Continence Society (ICS) definition of stress urinary incontinence (SUI)? What are the...

Paediatric urology – peno-scrotal

Case 1 A four-year-old boy presents to clinic following GP referral unable to retract the foreskin (Figure 1). Figure 1. What is the diagnosis? The above condition may be pathological or physiological; clinically how can you differentiate this? Explain the...

Botulinum toxin – from the sausage poison to urology

Botulinum toxin is the first biological toxin to be licensed for use in treating human disease and since its first therapeutic use in the early 1980s for strabismus has become widely used in the fields of ophthalmology, cosmetic surgery, migraine...

Guideline of guidelines – testosterone therapy for testosterone deficiency

The authors conducted an internet search and analysed guidelines for testosterone therapy (TTh) produced by the American Urological Association (AUA), European Association of Urology (EAU), American Association of Clinical Endocrinologists (AACE), British Society of Sexual Medicine (BSSM), Endocrine Society (ES),...

Managing sustainability

Planetary health needs to be addressed at a societal level for any meaningful impact to occur. As the global director of sustainability for a law firm, Marion Palmer provides an overview of the responsibilities of corporate organisations for both a...

Biomarkers in prostate cancer detection

Prostate cancer (PCa) is the second most common cancer in men with an estimated prevalence of 1.1 million worldwide in 2012. This heterogeneous disease resulted in approximately 307,000 deaths, making it the fifth leading cause of cancer-related death in men...

Upper tract abnormalities

Case 1 Figure 1. A 26-year-old female presents to A&E with loin pain. What do the CT images in Figures 1 (left, centre and right) show? What is the prevalence of the congenital anomaly in the general population, and is...