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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...

Mesh in urological surgery in the UK – background, reviews and current status

All UK urologists, unless they have been on a 10-year silent retreat, are by now aware of the controversy surrounding surgical use of mesh in general and urological / urogynaecological use of mesh for the surgical treatment of stress urinary...

Practical surgical management of chronic testicular pain

Chronic testicular pain (CTP) is defined as constant or intermittent, unilateral or bilateral testicular pain of more than three months’ duration, which significantly interferes with the daily activities of the patient prompting medical advice [1-4]. This condition is commonly seen...

Is laparoscopic urological training in Sub-Saharan Africa a goal worth pursuing? Observations from my experience with IVUmed in Senegal

Laparoscopic surgery has developed at an unimaginable pace over the last three decades. The first laparoscopic cholecystectomy was performed by Dr Phillip Mouret in France in 1987, with the first series of 63 cases published in 1989 [1]. However, its...

A negative ureteroscopy for stone disease: is it acceptable and is it avoidable?

Urinary tract stone disease and the consequent demand for endoscopic intervention in the upper urinary tract is an increasing phenomenon [1]. Although ureteroscopy is generally considered to be associated with low morbidity [2], risks do exist. Recognised complications include urothelial...

Priapism

Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...

The multidisciplinary team meeting: London calling!

The multidisciplinary team meeting, or MDT, is the foundation of cancer management in the UK. The MDT consists of a group of experts in different fields of medicine and surgery coming together at regular intervals to discuss the diagnosis and...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Mechanisms and prevention of catheterisation associated urethral injury (CAUI)

Urethral catheterisation is a common procedure performed by health professionals across different grades and specialties in a variety of clinical settings. An estimated 15-25% of hospitalised patients have a urinary catheter inserted during their inpatient stay and up to 13%...

Demanding cases or nightmares in uro-oncology? Jan/Feb 2022

When less is more: percutaneous biopsy and tumour seeding in papillary renal cell carcinoma Renal cell carcinoma (RCC) accounted for 2.2% of new cancer diagnoses worldwide in 2018 with over 400,000 new cases and 175,098 deaths [1]. The majority of...

Urinary diversion and infections

This article will be of interest to colleagues undertaking reconstructive surgery. Urinary diversions have been performed for decades. Common indications are muscle-invasive bladder cancer, neurological disorders, inflammatory conditions and congenital malformation. The diversions could be continent or non-continent. Complications due...

PUJO: Hellstrom principle revisited

This paper describes the result of four out of twenty-three cases (two males, two females) of pelvi-ureteric junction obstruction - PUJO - (mean age 18.25 years, range 16-20), mean follow-up two years (range six months – three years) that were...