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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...

Testicular cancer: management of stage I seminoma

Introduction Testicular cancer is the most frequently occurring solid tumour in men between the ages of 15 and 34 years [1]. About 60% of cases are seminomas and approximately 70-80% of them have, at presentation, clinical stage I disease. This...

The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

Can dogs smell prostate cancer?

For centuries we have known that man’s best friend has an exceptional sense of smell. ‘Sniffer’ dogs are found in a wide range of roles, including drug and explosive detection as part of airport security, helping emergency services locate survivors...

The scent of Ethiopia: a personal story – part 1

Background The year was 2004; I had just moved to the UK as a young house officer and finished my observership programme at Great Ormond Street Hospital in London. I was inspired by greats like Patrick Duffy and Phillip Ransley,...

‘One team’: our experience teaching catheter care and difficult urethral catheterisation to NHS Nightingale Hospital London volunteer staff members

The NHS Nightingale Hospital London was launched in response to the COVID-19 pandemic. In mid-March 2020, the predicted scale of the pandemic was uncertain and there was concern that COVID-19 might overwhelm existing intensive care unit (ICU) capacity within weeks....

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

Thermal ablative techniques for small renal masses

The incidence of renal cell carcinoma has increased over the past decade which can be partly attributed to the increased use of imaging modalities [1,2]. Nephron sparing procedures for the management of small renal tumours have gained popularity which include...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...

Surgical video – part 2: Tips on how to edit and create a finished surgical video for teaching or publication

A well-made and informative video can be one of the most valuable promotional tools for a department of urology. Having to resort to an external commercial source to produce a video can be prohibitively expensive. With the extensive computing power...

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...

Ejaculatory dysfunction – too swift, too slow and the no-show

Timing is everything.’ Although an expression most frequently linked to comedy, timing also seems just as critical in the business of sexual climax. Indeed, many men worry about ejaculating. Too soon is embarrassing. Too slow is frustrating. And not ejaculating...