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Genital gender affirmation surgery for transgender men

Genital gender affirmation surgery (GAS) is the final step in the transition journey for transgender men. Genital GAS involves a combination of procedures to surgically align physical characteristics with one’s gender identity. These needs change between each individual depending on...

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,...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study

Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

Physiotherapy first for pelvic floor dysfunction

Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...

HIV / AIDS – implications for the urologist

“It’s no fun to have HIV even though it’s viewed as a chronic, controllable disease. It means being wedded to the health system.” - Philip Berger, Associate Professor in the Department of Family and Community Medicine, Toronto, Canada; and leading...

Urodynamics in review: stress urinary incontinence in women produced by the Urodynamics Committee of the ICS

Urodynamic studies (UDS) are the best tools to objectively assess the lower urinary tract dysfunction (LUTD) of various aetiologies [1]. According to the general understanding and consensus of the medical community UDS should be performed only when they will change...

The expanding indications for ureteroscopy – ad maiora!

The management of urolithiasis is becoming a Herculean task for healthcare providers worldwide. The incidence of stone disease is rising, with predicted lifetime risk of 12% in males and 6% in females [1]. This rise relates to both improving imaging...

Moving hospitals as a consultant urological surgeon: what are the challenges?

Despite over 100 unfilled consultant urological surgeon posts in the UK, the reasons why an established surgeon should wish to move hospitals can still be viewed with suspicion. Why is this the case, when in many other careers, both within...

Radiological appearances of non-vascular renal anatomical variants

Anatomical variants of the renal tract are common and, although often asymptomatic, may present with complications. It is essential to identify anatomical variants, as this may have an impact upon surgical planning and management. This article aims to demonstrate radiological...