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The bilious solution of Monsieurs Calmette et Guérin

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). This month’s history story was inspired by a question from one of my...

Penile cancer

Case 1 A 67-year-old man presents with a worsening red patch over the past three months. It looks velvety in some areas. What is the most likely diagnosis? What are the risk factors? How do you classify this condition? How...

Keeping your eye on the ball: atypical presentations of testicular malignancy

Most testicular cancers present with a painless lump on the testes, and most are confidently diagnosed on examination and ultrasound. They have an excellent prognosis, with 90% patients alive at 10 years [1]. However, advanced testicular cancer, or those with...

Prostate cancer series: diagnostics 1

- Click here for Part 2 - A 58-year-old male is referred to your rapid access prostate clinic with a prostate specific antigen (PSA) of 6.0ng/ml. He has no lower urinary tract symptoms (LUTS), past medical history (PMH), or family...

Imaging of varicoceles

A varicocele is a collection of dilated, tortuous spermatic veins of the pampiniform venous plexus. It is seen in 10-15% of the general population and is associated with both primary and secondary infertility. A varicocele is the most common cause...

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...

Cutting-edge or over-hyped? Evaluating the role of robotic surgery in the management of renal cell carcinoma

The quest for a minimally-invasive approach to major abdominal surgery finds its roots at the start of the previous century, when Georg Kelling first described the technique of ‘ceolioscopy’ to inspect intraabdominal organs in 1901 [1]. Since those early days,...

Clear cell urothelial carcinoma: a highly aggressive morphological variant in the bladder and upper urinary tract

Clear cell urothelial carcinoma (CCUC) is a rare morphological variant of transitional cell carcinoma (TCC). It can occur anywhere along the urothelial tract and is characterised histologically by high grade carcinoma with an abundance of clear, glycogen-rich cytoplasm [1]. Alternative...

Recent developments in bladder cancer – MIBC

This article takes a look back over recent years at new innovations and developments relating to muscle-invasive bladder cancer (MIBC) specifically, and will also touch upon what the future may hold. This article is also written as a continuation of...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Tissue-based biomarkers steering clinical decisions in patients with urothelial cancer

Biomarkers play an essential role in the diagnosis and treatment of urothelial cancer (UC), with PD-L1, FGFR, and MMR proteins being the most clinically established. These biomarkers, derived from histological specimens, guide therapeutic decisions for bladder cancer (BCa) and upper...

The adrenals

Case 1 A 45-year-old man undergoes a CT of his abdomen to stage a newly diagnosed bowel malignancy. What does the scan show? What findings on a CT scan suggest an adrenal lesion is benign? If the CT scan is...