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Prostate cancer management 2 – metastatic disease

A 72-year-old gentleman is referred to you in the two-week wait clinic with a prostate specific antigen (PSA) of 22ug/L. He is otherwise fit and well and does not take any regular medication. His multi-parametric magnetic resonance imaging (mpMRI) shows...

Conference apps

With conference season soon starting I thought I would run through some of the apps I think would be useful for delegates attending a urology conference in the coming year. The conference app It is often useful to download the...

Reflections on 20 years as an Army Reserve doctor: live a life less ordinary

It seems a very short time ago that my predecessor recruited me into my regiment as a surgical senior house officer during a varicose vein operation in a cottage hospital in Stroud, informing me that I would be only the...

Dietary citrate substitution in urolithiasis patients

Stone formation is dependent on supersaturation of urinary salts and urinary crystal retention. Urinary promoters (protein aggregates, cell debris) and inhibitors (citrate, magnesium, urinary macromolecules such as glycosaminoglycans and proteins) are involved in the process of stone formation [1]. Hypocitraturia...

The multidisciplinary team meeting: London calling!

The multidisciplinary team meeting, or MDT, is the foundation of cancer management in the UK. The MDT consists of a group of experts in different fields of medicine and surgery coming together at regular intervals to discuss the diagnosis and...

PREDICT Prostate – individualised, evidence-based estimates of survival and treatment benefit

Earlier this year ‘PREDICT Prostate’ was launched online alongside a high-profile publication in PLOS Medicine. The prognostic model and decision-aid has been designed to inform treatment decision-making among men newly diagnosed with non-metastatic prostate cancer. David Thurtle and Vincent Gnanapragasam...

How to clear backlogs after Covid-19

With clinics and surgery postponed, we can help your patients with cystitis and...

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...

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...

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]...

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...

Innovations in flexible ureteroscopy for renal calculi: a comprehensive review

This article has been verified for CPD. Click the button below to answer a few short questions and download a form to be included in your CPD folder. Flexible ureteroscopy (f-URS) has become a core modality in the treatment of...