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Guideline of guidelines – testosterone therapy for testosterone deficiency

The authors conducted an internet search and analysed guidelines for testosterone therapy (TTh) produced by the American Urological Association (AUA), European Association of Urology (EAU), American Association of Clinical Endocrinologists (AACE), British Society of Sexual Medicine (BSSM), Endocrine Society (ES),...

Advanced prostate cancer and chemotherapy

The treatment pathway for advanced prostate cancer is both puzzling and complex and varies from centre to centre in the UK. The National Prostate Cancer Audit Report 2019 for England and Wales shows that only a quarter of men with...

COVID-19: cancer and corticosteroids

Under the prevailing COVID-19 crisis, this article is well worth reading. The current World Health Organization (WHO) guidance is not to start steroids in cancer cases, but there is no clear evidence of risks with steroids in cancer patients having...

TIP hypospadias repair

This paper by one of the current international leaders in hypospadias surgery looks at the outcome of over 1800 consecutive hypospadias repairs using the tubularised incised plate (TIP) repair, beginning from the first original operation through to sequential modifications over...

Male genital mysteries

Every now and then urologists are asked to give an opinion on genital lesions and rashes. This article from University College Hospital London is certainly worth a read. Most conditions are benign but some are precancerous leading to penile cancer...

Pacemakers in the upper urinary tract

This is an interesting study from Italy. The mechanism by which urine is transported from the kidney to the bladder via the upper urinary tract (UUT) remains poorly understood and elusive. For many years, pyeloureteric rhythmicity is thought to arise...

Post-orgasmic illness syndrome

Introduction Disorders of ejaculation are a rare and poorly understood subsection of male sexual dysfunction. A paucity of evidence has hindered advances in definitions, epidemiology, pathophysiology and management. The licensing of a specific medication for premature ejaculation signalled the research...

Management of urological issues following genital gender affirmation surgery for individuals assigned female at birth

Gender incongruence arises when there is a mismatch between an individual’s gender identity and their sex assigned at birth. Genital gender affirmation surgery (GAS) is the final step of transition for transgender and non-binary individuals who experience gender incongruence. This...

Guide to gaining approval for a clinical study

This article focuses on gaining approval for clinical research involving NHS patients, although the principles can be applied to other types of research. It can be quite a daunting process for the uninitiated applicant. Often it can be made less...

OCERT: a new multi-specialty project to standardise robotic surgical training

Since its introduction by Dr William Osler in 1890 to the Board of Trustees at John Hopkins Hospital [1], the Halstedian ‘See one, do one, teach one’ has represented a guideline for surgeons worldwide, both for open and laparoscopic surgery,...

Consent

See Part 2 on this topic here Case 1 A 15-year-old boy attends with his father to have a circumcision on a day case list. He had been seen previously by a colleague and noted to have a tight phimosis...

LUTS update

Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...