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The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

Comparison of pathological stage in patients treated with and without neoadjuvant chemotherapy for high-risk UTUC

High-risk upper tract urothelial carcinoma (UTUC) has been associated with poor survival outcomes. The authors evaluated the role of neoadjuvant chemotherapy in high-risk cases prior to radical nephroureterectomy (RNU) in terms of pathological stage of the final surgical specimen. A...

A greener urology

Healthcare in England is responsible for 4-5% of the country’s carbon footprint which is defined as the amount of greenhouse gasses, primarily carbon dioxide, released into the atmosphere by a particular activity. The six greenhouse gasses which vary in their...

Obesity and Urologic cancers: A student’s perspective on risk, systems and surgical implications

During my clinical placements, I began to notice that some patients did not fit neatly into the scenarios we learned about in lectures. One patient in particular had a raised PSA and several comorbidities, including obesity. What stood out was...

Are standard repeat biopsies during active surveillance for prostate cancer still necessary?

Active surveillance (AS) has emerged as a key strategy for managing low-risk prostate cancer (PCa), offering an alternative to immediate treatment. Initially, AS relied on prostate specific antigen (PSA) testing, digital rectal examinations (DRE), and systematic biopsies. Early studies using...

The life of a urology trainee in Singapore

Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...

The emerging role of physician associates in urology

The physician associate (PA) is a new role in the NHS which has expanded across medical and surgical specialties to include urology. In the USA, it has long been an established field of practice where physician assistants work autonomously within...

Demanding cases or nightmares in endourology? Nov/Dec 2017

Case 1 A 78-year-old male was transferred from a referring hospital. He had a cystectomy and ileal conduit performed 15 years previously and had recently been admitted with a clinical diagnosis of an infected obstructed kidney. The referring hospital had...

Intravesical glycosaminoglycan analogue instillations for recurrent cystitis

Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....

Preventive pharmacological therapy for kidney stones

Kidney stones are common, painful and are a chronic disease with a high lifetime risk of recurrence. Without treatment 35-50% of patients experience a second stone within five years of their first experience. Thiazide diuretics, alkali citrate treatment and allopurinol...

Dual therapy for OAB in children

Overactive bladder (OAB) is a disorder frequently encountered by the paediatric urologist. Morin et al. report the results of the first known study on the efficacy of mirabegron (a β3 adrenoceptor agonist) as add-on therapy in paediatric patients with refractory...

Psychosocial and sexual outcomes after surgery for proximal hypospadias

Andersson et al. report the psychosocial and sexual outcomes for adolescents treated previously for proximal hypospadias. They hypothesised outcomes would be negatively affected compared to patients with distal hypospadias or age-matched controls (Swedish population registry). Participants answered a web-based questionnaire...