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Buccal grafts for urethroplasty in pre-pubertal boys

Buccal mucosa graft (BMG) is often used as the primary graft in complex hypospadias surgery. It is not clear what the response of this BMG is during puberty androgen surge and whether or not differential penile growth occurs with secondary...

Urinary diversion and infections

This article will be of interest to colleagues undertaking reconstructive surgery. Urinary diversions have been performed for decades. Common indications are muscle-invasive bladder cancer, neurological disorders, inflammatory conditions and congenital malformation. The diversions could be continent or non-continent. Complications due...

Keep an eye on Viagra™

Many of the side-effects and contra-indications of sildenafil and other phosphodiesterase 5 (PDE 5) inhibitors for erectile dysfunction have become well known to doctors and pharmacists over the years. This study from the United States collected case reports of adverse...

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...

Prostatic artery embolisation – an option for select BPO patients

Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...

Intravesical instillation of chemotherapy before radical surgery for upper UTUC

Upper urinary tract urothelial carcinoma (UTUC) is a rare but increasingly prevalent form of urothelial cancer, accounting for 5–10% of cases, with an annual incidence of two to three cases per 100,000 individuals in Western Europe. Radical nephroureterectomy (RNU) with...

Induction Switch

Changing medical jobs or working in multiple hospitals is often a frustrating experience. Switch wait times can be agonisingly long, and at least in my experience, hospital intranet telephone directories are frequently inaccurate and unhelpful in connecting to the relevant...

Anti-VEGF and PD-1 combinations in renal cell carcinoma

Over the past decade, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs) have been central to treating renal cell carcinoma (RCC), with oncologists refining dosing strategies to balance treatment efficacy with quality of life (QoL). Recently, the introduction of...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

The scent of Ethiopia: a personal story part 2

In May/June 2016 we featured a wonderful account of Zeeshan Aslam’s first trip with Urolink to the Hawassa Referral Hospital in Ethiopia (see here). One year on we are delighted that Zeeshan has once again taken the time to provide...

Prostate cancer

Case 1 A 65-year-old man is referred to your two-week wait (2WW) clinic with a PSA of 7.0ng/mL. He has no lower urinary tract symptoms (LUTS), no past medical history, no family history of prostate cancer (PCa) and his performance...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...