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An effective new solution for chronic pelvic pain patients

The Feel Free Programme is a safe, effective innovation which addresses the overwhelming caseload pressure on clinics because patients can start right now...

Demanding cases or nightmares in uro-oncology? Sep/Oct 2021

Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...

Demanding cases or nightmares in uro-oncology? Sep/Oct 2022

Treatment of prostate cancer in renal transplant recipients is challenging due to a lack of knowledge of the natural history of cancer in these patients, the anatomical position of the graft in the iliac fossa and its proximity to the...

A sigma six approach to improving nephrostomy and antegrade stent services at a district general hospital – an audit project

As hospitals merge into larger trusts there becomes a centralisation of some services. Interventional radiology (IR) has been one of those services. Our district general hospital runs bi-weekly lR lists following service centralisation. Urology and IR most commonly liaise on...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

Burnout in surgery

When I was pregnant with my first child, I went to a talk on how to achieve work-life balance and avoid burnout. It was given by a highly respected Australian surgeon and I was eager to hear the secrets that...

Hard flaccid syndrome

Chronic pelvic pain is defined as pain present below the level of the umbilicus with a duration of more than six months [1,2]. Chronic pelvic pain syndromes (CPPS) are highly prevalent in Western society, affecting both males and females. Studies...

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...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...

Indeterminate renal lesions – a pragmatic imaging approach

The incidence of renal cell carcinoma (RCC) in the UK has increased steadily over the last two decades, largely driven by the increasing use of abdominal imaging and the incidental detection of small renal lesions [1]. The majority of incidental...

Surgical treatment of LUTS secondary to BPH

For the vast majority of patients an initial trial of medical therapy for the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is indicated [1]. In a substantial minority of cases however, a surgical intervention...

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...