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Indeterminate renal lesions – a pragmatic imaging approach

The incidence of renal cell carcinoma (RCC) in the UK has increased steadily over the last two decades, largely driven by the increasing use of abdominal imaging and the incidental detection of small renal lesions [1]. The majority of incidental...

Priapism in sickle cell disease

What is sickle cell disease? Sickle cell disease (SCD) is one of the most common single-gene disorders in the UK affecting approximately one in every 2000 live births. Approximately 20-25 million people worldwide have SCD. It predominately affects those of...

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...

Nurse practitioner TRUS biopsy: training and preparation

As prostate cancer rates increase, many urology departments rely on multi-professional teams to diagnose and manage patients with prostate cancer. The aim of this article is to highlight the skills, training and preparation required for nurse practitioners to undertake trans-rectal...

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...

The doctor as the patient: receiving bad news

This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

All you need to know about percutaneous nephrolithotomy: supine versus prone and mini versus traditional

Introduction Since the first percutaneous nephrolithotomy (PCNL), the technique has undergone many innovations, including modifications in positioning, miniaturisation of instruments and combination with retrograde intra-renal surgery (see Table 1 for an outline of the history of the technique). Controversy has...

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...