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Demanding cases or nightmares in uro-oncology? Sep/Oct 2022

Treatment of prostate cancer in renal transplant recipients is challenging due to a lack of knowledge of the natural history of cancer in these patients, the anatomical position of the graft in the iliac fossa and its proximity to the...

Retroperitoneal sepsis

Case 1 An 80-year-old woman presented with history of recurrent and recent cystitis, low grade pyrexia, abdominal and back pain, and pain on movement of the left hip which was observed to be flexed and externally rotated. What is the...

An overview of daytime wetting in children

It is estimated that daytime wetting affects one in seventy-five children over the age of five years [1]. Daytime wetting is commoner in younger children (1 in 7 aged 4.5 years, 1 in 20 aged 9.5 years) [1]. Many younger...

PSA screening in limbo: how low should we go?

One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...

The life of a urology trainee in Singapore

Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...

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...

The role of conservative renal colic treatment

Acute renal colic is a common emergency condition, which can arise from a variety of underlying conditions that affect the urinary tract, but it is usually associated with the passage of ureteral stones. Before considering expectant management or active intervention,...

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...

Improving on the Rotterdam Prostate Cancer Risk Calculator

Following the PROMIS trial [1], many cancer centres in the UK are now offering pre-biopsy multiparametric MRI (mpMRI) for men suitable for radical treatment. The European Association of Urology for Prostate Cancer (PCa) guidelines recommend individual risk stratification before the...

Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...

Male LUTS: where do we stand?

Patients’ preferences and expectations depend on cultural, geographical, economic and national factors. Data from different countries should be interpreted with caution when applied to the individual patient. Patients rarely seek help for benign prostatic obstruction (BPO) unless urinary retention occurs,...

Day-case monopolar and bipolar transurethral resection of the prostate

The aim of this study was to assess the safety and efficacy of performing monopolar (mTURP) and bipolar transurethral resection of prostate (bTURP) as a day-case. This was a prospective two-centre study. One centre performed day-case mTURP (group M) and...