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Fournier’s gangrene
Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...
Cystitis Unmasked
Cystitis is often viewed as a heartsink diagnosis, and sometimes one of exclusion. The aetiology is multifactorial and misunderstood. Treatment has been based on dogma, and poor clinical and scientific evidence. The truth is, that despite the significant morbidity caused...Urology around the world: Myanmar
In this article the author, a urologist from Myanmar, discusses the presentation, diagnosis and management of a condition common in his country. Urethral orifice stones Urolithiasis is one of the most common urological conditions, usually involving the kidneys, ureters and...
Stepwise voltage ramping causes less renal haematomas than fixed maximal voltage ESWL
Extracorporeal shock wave lithotripsy (ESWL) remains the recommended first line treatment for stones <2cm in the renal pelvis and upper or mid-pole calyces (Türk C, Knoll T, Petrik A, et al. European Association of Urology Guidelines on Urolithiasis. 2014). There...
Predicting resolution of the primary obstructed megaureter
Primary obstructive mega ureter (POM) is the congenital dilatation of the ureter in the absence of other structural urinary tract anomalies and comprises 10–20% of prenatal hydronephrosis cases. It is often detected during workup for prenatal hydronephrosis and confirmed using...Medical Protection: Expertise, advocacy, and support when it matters most
The world’s leading medical defence organisation providing long-term protection against the potentially ruinous costs of litigation, as well as the other professional challenges that healthcare professionals might face during the course of their career. As a doctor your work is...Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?
The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...Urological trauma – part 2
Part 1 of this topic is available here. Case 1 A 29-year-old male was attacked and kicked in his left flank. He presented to the emergency department with left flank pain and frank haematuria. He remained haemodynamically stable. 1. What...
BCG after TURBT – does timing matter?
Intravesical bacille Calmette–Guerin (BCG) therapy continues to be widely used for patients with intermediate / high-risk non-muscle invasive bladder cancer (NMIBC). In this article, the researchers identified the lack of sufficient evidence with regards to timing of BCG after transurethral...Obesity and Urologic cancers: A student’s perspective on risk, systems and surgical implications
During my clinical placements, I began to notice that some patients did not fit neatly into the scenarios we learned about in lectures. One patient in particular had a raised PSA and several comorbidities, including obesity. What stood out was...
