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The final hurdle: the consultant interview

The consultant interview is undoubtedly the most important exam you’ll ever sit; but curiously even the best and most motivated trainee becomes somewhat fatalistic when approaching this, the most important of all hurdles. Gone are the days when deals were...

Frailty in urology – part 2

The first article in this series defined frailty and introduced the concept and importance of identifying patients living with frailty who undergo surgery, including those undergoing urological procedures. In the second part of this series we outline how to identify...

Uroscopy

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). You may feel somewhat distanced from the medical practitioners of mediaeval Florence but...

Nephrocalcinosis

Case 1 What does this x-ray of the kidney, ureter and bladder (KUB) show? What are the likely causes? What is the pathology behind medullary sponge kidneys (MSK)? What is the risk of urolithiasis with MSK? How are such patients...

Artificial intelligence

Artificial intelligence concerns me. Generally, people still tend to be concerned that their livelihoods will be replaced by an all powerful, all knowing artificial intelligence (AI) system. This at a time when the world’s largest technology companies (Amazon, Google, Apple),...

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...

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...

Long-term oncologic outcomes of salvage cryoablation for rrPC

Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...

MSKCC prostate cancer screening guidelines – is it the way forward?

The Memorial Sloan Kettering Cancer Center (MSKCC) developed prostate cancer screening recommendations first in 2011 as a response to three limitations of previous screening guidelines: insufficient evidence base, failure to link screening with treatment, and lack of risk stratification. To...

Onabotulinum toxin A (BTX) not helpful for chronic scrotal pain

It is refreshing to read a report on negative outcomes as it reinforces the honesty that is often lacking with the well-known publication bias in medical publications. It is also not common to come across surgical randomised controlled trials (RCTs)...

Is robotic pyeloplasty in the under-ones as good as open repair?

Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...

Robot-assisted ureterocalicostomy

Ureterocalicostomy was first introduced by Neuwirt (1947) and further described by Jameson et al. (1957) as an alternative procedure for repair of pelviureteric junction (PUJ) obstruction associated with an intrarenal pelvis. Performing ureterocalicostomy for PUJ repair has been suggested in...