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Nephrocalcinosis

Case 1 What does this x-ray of the kidney, ureter and bladder (KUB) show? What are the likely causes? What is the pathology behind medullary sponge kidneys (MSK)? What is the risk of urolithiasis with MSK? How are such patients...

Infections and inflammation: Part 2

See also Part 1 and Part 3. Case 1 A 43-year-old lady presented to the urologist with a history of pain during bladder filling and associated frequency / urgency. She underwent standard microbiological and radiological investigations that are normal. She...

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...

A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Erectile Dysfunction Part I: pathophysiology and risk factors

Introduction Erectile dysfunction (ED) is defined as the inability to achieve and maintain a penile erection, which is adequate for satisfactory sexual intercourse. The Massachusetts Male Ageing Study (MMAS) reported the results of a regional survey of men aged 40–69...

Pyonephrosis: is the kidney always doomed?

Pyonephrosis (Greek pyon ‘pus’ + nephros ‘kidney’) is defined in Campbell-Walsh Urology [1] as an infected hydro-nephrosis associated with suppurative destruction of the renal parenchyma which results in total or near total loss of renal function. The true incidence of...

Urine leak post partial nephrectomy: a case for lower tract before upper tract

Partial nephrectomy has become the standard of care in the management of small renal masses. It is a vital tool in maximising nephron preservation and oncological control for patients. It has been shown to produce equivalent oncological outcomes to radical...

Feeling like a fraud — imposter syndrome: what it is and what to do about it

Have you ever been plagued by feelings of incompetence despite evidence to the contrary, then this article is for you. Dr Dunay Schmulian provides insight into imposter syndrome and what to do about it. Excerpt 1 Consultant:That was excellent, and...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Testicular microlithiasis

Introduction Testicular microlithiasis (TML) was originally described in 1970 in a healthy four-year-old boy [1] and the first paper regarding microlithiasis as an entity seen on ultrasound was published in 1987 [2]. Testicular microlithiasis is seen on ultrasound as small,...

Imaging of varicoceles

A varicocele is a collection of dilated, tortuous spermatic veins of the pampiniform venous plexus. It is seen in 10-15% of the general population and is associated with both primary and secondary infertility. A varicocele is the most common cause...

Retroperitoneal fibrosis

Introduction Retroperitoneal fibrosis (RPF) is a condition that occurs when extensive fibrosis develops in the retroperitoneum, usually centred over the anterior aspect of the fourth and fifth lumbar vertebrae. The fibrotic tissue typically surrounds the infrarenal aorta, inferior vena cava...