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Assessment of the incidental adrenal lesion

Introduction The adrenal glands are seen on CT or MRI surrounded by fat in the peri-renal space. The right adrenal gland lies medial to the right lobe of the liver, lateral to the right crus of the diaphragm and superior...

Covid-19, cancer, and other calamities

The coronavirus (Covid-19) pandemic is upon us. The government and NHS are going full-steam ahead with their preparations for the onslaught, freeing up operating theatres, intensive care units, and even private hospital beds and staff, to accommodate the expected influx...

Use of bone windows in urological CT

Introduction Unenhanced computed tomography of kidneys, ureter and bladder (CTKUB) is the recommended gold standard investigation in patients with acute renal colic. CT urography is now a commonly used technique in the investigation of haematuria, for surgical planning and for...

Localised renal cancer

Case 1 A 56-year-old lady is referred to the urology clinic after the GP conducted an ultrasound abdomen for deranged liver function tests and found a renal lesion. She is otherwise fit and well. Figure 1. What is the sensitivity...

Prenatal spina bifida repair – does it have urological benefits in the longer term?

At present, I have one patient under my care who underwent prenatal closure of his spina bifida defect. Only with time, will we be able to determine whether this intervention has been of benefit for him from a urological standpoint....

Advanced renal tumours

Case 1 A 67-year-old gentleman underwent a CT scan after presenting with visible haematuria and weight loss. His comorbidities include hypertension, type II diabetes mellitis and hypercholesterolaemia. He is a smoker. Figure 1. Figure 2. What do Figures 1 and...

Prostate cancer spit test could save the NHS £500 million a year

Thousands of men could have their prostate cancer diagnosed at an earlier stage when it is easier and cheaper to treat, thanks to a new spit test which can be taken at home. An innovative new study launched this week,...

Curing pure CIS with radical surgery: lessons learned

As carcinoma in situ (CIS) theoretically has no ability to invade or metastasise, performing radical cystectomy for CIS-only disease should be curative. In this single centre review over 37 years, 1964 patients undergoing cystectomy were analysed with 52 undergoing surgery...

Outcomes of sarcomatoid differentiation in urothelial carcinoma

Sarcomatoid differentiation is a rare variant of urothelial carcinoma (UC) seen in 0.6% of cases. Its response to neo-adjuvant chemotherapy (NAC) has not been well reported. The authors have done a retrospective analysis of patients undergoing cystectomy between 1995 and...

Demanding cases or nightmares in uro-oncology? May/Jun 2022

Delayed diagnosis of testicular cancer Testicular cancer is considered rare in the general population but is the most common cancer affecting males between 24 and 49 years. The diagnosis of testicular cancer depends on physical examination, ultrasound findings and tumour...

Ureteral clipping in children – longer term outcomes of a novel treatment

In this article, Lopes et al. report longer term outcomes of laparoscopic clipping of ureters of non-functioning kidneys or non-functioning renal moieties in duplex kidneys associated with ectopic ureter or obstructive ureteroceles. In 2014, their group published a promising preliminary...

Is robotic pyeloplasty in the under-ones as good as open repair?

Pelviureteric junction obstruction (PUJO) is a common cause of paediatric hydronephrosis. Indications for intervention include reduced renal function (<40%), symptoms (urinary tract infection or pain) and increasing dilatation. Although the Anderson-Hynes open pyeloplasty (OP) has long been the gold standard...