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Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

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...

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...

Smoking and urological health

European Urology Focus is a new sister journal to European Urology. It is peer-reviewed and will be published six times per year in electronic format. The first issue deals with smoking and urological diseases. It makes for very interesting reading...

Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?

Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...

Complications of CISC

Introduction Clean intermittent self catheterisation (CISC) was first introduced and popularised by Lapides in 1972. Since then its utilisation has become widespread and it is now commonly used throughout the world as the preferred means of facilitating complete and effective...

Surgical risk prediction

Patients presenting for urological surgery range from the young and fit to the elderly with multiple, and often significant, coexistent diseases. This latter cohort can present a significant challenge in the perioperative period, sometimes irrespective of the type of surgery....

What is the significance of prostatic calcification?

This prospective study on men undergoing transrectal ultrasonography (TRUS) biopsies was performed to evaluate the prevalence and to classify prostatic calcification (PCalc) on TRUS and correlate the findings with histology. Images of the prostate were saved at three defined regions:...

Renal masses

Case 1 A 70-year-old female presented under the medical team with malaise, weight loss, and deranged liver function tests (LFTs) and calcium (ALP 350, GGT 650, Serum bilirubin 29, normal aminotransferases, Ca 3.3). An abdominal ultrasound scan (USS) was performed...

Synthetic mid-urethral slings for stress incontinence in neurogenic LUTD

Neurogenic lower urinary tract dysfunction (NLUTD) is heterogeneous because of the multiplicity of underlying causes and mechanisms. In women with NLUTD, stress urinary incontinence may be due to intrinsic sphincter deficiency caused by the neurological disease itself or from sphincter...