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Management of stage 1 non-seminomatous germ cell tumours

Testicular cancer (TC) is the most successfully treated solid tumour, achieving a cure rate of 90-95% [1-3]. Testicular cancer is relatively rare with an incidence of 2207 cases in the UK in 2014 [4] and yet is the most common...

The workplace environment and doctors’ health

It is well established that doctors have higher levels of stress, depression and suicide than the general population [1] and most other professional groups. In addition they have high levels of ‘burnout’. Research indicates that although burnout is correlated with...

Functional and reconstructive urology

Case 1 A 45-year-old female presents with a one-year history of urinary leakage, especially worse on coughing. She is otherwise well, with no co-morbidities. What is the International Continence Society (ICS) definition of stress urinary incontinence (SUI)? What are the...

The Mitrofanoff procedure: a continent revolution

Prior to 1980, surgeons had been struggling to provide a catheterisable, continent channel as an alternative to the native urethra, primarily for paediatric patients with congenital neuropathic bladder. In 1980, Professor Paul Mitrofanoff described the continent supravesical antireflux appendicovesicostomy [1]...

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...

Thermal ablative techniques for small renal masses

The incidence of renal cell carcinoma has increased over the past decade which can be partly attributed to the increased use of imaging modalities [1,2]. Nephron sparing procedures for the management of small renal tumours have gained popularity which include...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

Penile fracture

Traumatic rupture of the tunica albuginea with either one or both corpora cavernosa of the penis is known as penile fracture. This may be associated with corpus spongiosum or urethral injury. Incidence Penile fracture was reported for the first time...

Meeting in the middle: a review of the rendezvous technique to treat impassable ureteric strictures and transected ureters

Introduction Complex ureteric strictures present a significant challenge with some patients undergoing multiple separate urological and radiological procedures to try to cross a stricture without success. Cross-departmental collaboration with uroradiology may allow a decrease in the number of separate interventions....

The conservative assessment and treatment of mixed urinary and anal incontinence in women: a multidisciplinary approach

Mixed urinary incontinence Urinary incontinence (UI) is considered to be a highly prevalent condition; however, depending upon the definitions used, actual reported prevalence rates can vary significantly. The International Consultation on Incontinence (ICI) review [1], reported unadjusted prevalence estimates for...

Ejaculatory dysfunction and the treatment of LUTS

For years ejaculatory dysfunction in men following medical or surgical treatment of lower urinary tract symptoms (LUTS) was thought to be a result of disruption of the bladder neck mechanism and the subsequent retrograde flow of semen. Men commenced on...

What exactly is Hinman Syndrome?

Who was Hinman and what is Hinman Syndrome? Frank Hinman Junior (1915–2011) first described ‘Hinman syndrome’ in the 1970s – a condition also known as a ‘non-neurogenic neurogenic bladder’. He was a renowned American urologist, educator and skilful artist and...