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An inconvenient truth: reflections on the NHS
“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...
Upper tract urothelial carcinoma following cystectomy
Metachronous upper tract urothelial cancer (UTUC) is encountered in about 5% of patients after radical cystectomy (RC) with a median time to diagnosis of 24-36 months after RC, and most are asymptomatic and detected by surveillance protocols. In this multivariate...
Prostate cancer and an electronic nose
So far the transrectal ultrasound guided (TRUS) biopsy has been the ‘gold standard’ for diagnosing prostate cancer. However, it is invasive and can lead to complications, so there is a need for new non-invasive diagnostic tools to avoid unnecessary biopsy...The COVID-19 ‘frontlines’: a foundation doctor’s perspective
Staring through the fragmented stained glass of the Virgin Mary and her assorted angels, I reflected on the strangeness of the workplace I now found myself in and the irony of a workforce now working together more enthusiastically than ever...A short history of nephrectomy
In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last article I promised to tell you about removing kidneys, by...
Prostate cancer mortality among elderly men after discontinuing organised screening
This study presents ground-breaking insights into discontinuing prostate cancer (PCa) screening in previously screened elderly men, aiming to mitigate the risk of overdiagnosis and overtreatment in the face of other-cause mortality. Examining men aged 70–74 who had undergone prostate specific...
Is routine renal tumour biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?
There has been a considerable increase in the detection of small renal masses (SRM). Approximately 20% of these turn out to be benign lesions on final histopathological analysis. Therefore upfront surgery can be overtreatment in such a group of patients....
Performance of non-invasive tests in diagnosing BOO in men with LUTS
A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...
Efficacy of flexible ureteroscopy and laser lithotripsy for lower pole renal calculi
The management of lower pole renal stones (LPS) is often difficult. Extracorporeal shock wave lithotripsy (ESWL), flexible ureterorenoscopy (fURS) and percutaneous nephrolithotomy (PCNL) are all potential options with potential benefits and disadvantages. In order to assess the success of fURS...
PDE5I in LUTS – how do they work – no proof yet
Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study
Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...
