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Demanding cases or nightmares in uro-oncology? Sep/Oct 2021

Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...

Infections and inflammation: Part 2

See also Part 1 and Part 3. Case 1 A 43-year-old lady presented to the urologist with a history of pain during bladder filling and associated frequency / urgency. She underwent standard microbiological and radiological investigations that are normal. She...

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...

Seminal vesicle calculi

Epidemiology Seminal vesicle calculi are uncommon with just over 100 cases being reported in the literature, although the true incidence is likely to be higher [1-9]. Patients usually present aged between 30 and 45 years old and although the pathogenesis...

A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Urology around the world: Myanmar

In this article the author, a urologist from Myanmar, discusses the presentation, diagnosis and management of a condition common in his country. Urethral orifice stones Urolithiasis is one of the most common urological conditions, usually involving the kidneys, ureters and...

Male infertility

Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...

Management of calyceal diverticular stones using ultramini PCNL

Calyceal diverticulae are congenital smooth-walled, non-secretory urothelium-lined cavities within the renal parenchyma that communicate with calyceal fornix through a diverticular neck. They were first described by Rayer in Traitements des maladies des reins [1]. Calculi occur in approximately 9.5% to...

Retroperitoneal fibrosis

Introduction Retroperitoneal fibrosis (RPF) is a condition that occurs when extensive fibrosis develops in the retroperitoneum, usually centred over the anterior aspect of the fourth and fifth lumbar vertebrae. The fibrotic tissue typically surrounds the infrarenal aorta, inferior vena cava...

The bulbocavernosus reflex

Despite its first discovery predating the early-1940s, clinical application of the bulbocavernosus reflex (BCR) has been limited to date. The BCR traditionally involves contraction of the bulbo- and ischiocavernosus pelvic floor muscles, often referred to as the ‘bulbocavernosus muscle’, in...

Understanding Stauffer’s syndrome

Who was Stauffer and what is Stauffer’s syndrome? Maurice Stauffer (1915-1994) was a gastroenterologist at the Mayo Clinic in Rochester, United States, and in 1961 first characterised the non-metastatic, paraneoplastic effects of renal cell carcinoma (RCC) on liver size and...

In conversation with James Green

We were delighted to catch up with James Green, Consultant Urological Surgeon and new President of the Royal Society of Medicine Section of Urology. Can you tell us a little bit about what led you into the field of urology...