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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...Nocturia – the Cinderella of lower urinary tract symptoms
Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...Lifestyle interventions for UI in women
Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...A guide to percutaneous nephrolithotomy
Percutaneous nephrolithotomy (PCNL) is now the gold standard approach to treating large renal stones. Since its development in the 1970s, it has undergone a series of refinements that could only have been possible with the symbiosis of both radiological and...Challenges of catheter associated urinary tract infection: is prevention better than cure?
Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...
Prostatic artery embolisation – an option for select BPO patients
Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study
Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...Demanding cases or nightmares in uro-oncology? May/Jun 2021
It’s not in the bag until it’s out of the abdomen: abdominal wall recurrence after ruptured retrieval bag during robot-assisted partial nephrectomy We present a case of failure of a specimen retrieval bag during a robot-assisted partial nephrectomy resulting in...The doctor as the patient: receiving bad news
This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...
Performance status may alter outcomes in those treated with abiraterone
The drug therapies available for those with metastatic castrate-resistant prostate cancer have increased over the past few years. Abiraterone, a CYP17 inhibitor, has been proven effective in phase three trials, however those with poor performance status were largely under-represented in...
Radium-223 treatment outcomes after multiple lines of mCRPC therapy in clinical practice: implication of pre-treatment spinal epidural disease
There are a number of treatments now available to patients with metastatic castrate-resistant prostate cancer (mCRPC). However, the optimal timing and order in which they are given is less clear. Radium-223 was FDA-approved for mCRPC patients with symptomatic bone metastases...
