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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...

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...

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...

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%...

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...

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...

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...

Inpatient care of patients with established spinal cord injury - what a general urologist needs to know

Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...

Endoscopic management of upper tract urothelial carcinoma

Upper tract urothelial carcinoma (UTUC) is a rare disease accounting for 5-10% of all urothelial carcinomas and has an annual incidence in Western countries of 1-2 per 100,000 [1,2]. It occurs more commonly in the pelvicalyceal system as opposed to...