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Impact of prostatic apex in continence after RARP

This article investigates the impact of prostatic apical shape from preoperative magnetic resonance imaging (MRI) on early recovery of urinary continence after robot-assisted radical prostatectomy (RARP). It is a retrospective study of 1011 patients at a tertiary centre. Patients were...

Keeping your eye on the ball: atypical presentations of testicular malignancy

Most testicular cancers present with a painless lump on the testes, and most are confidently diagnosed on examination and ultrasound. They have an excellent prognosis, with 90% patients alive at 10 years [1]. However, advanced testicular cancer, or those with...

Post-orgasmic illness syndrome

Introduction Disorders of ejaculation are a rare and poorly understood subsection of male sexual dysfunction. A paucity of evidence has hindered advances in definitions, epidemiology, pathophysiology and management. The licensing of a specific medication for premature ejaculation signalled the research...

Does empowering men on active surveillance for prostate cancer improve patient compliance and reduce conversion to treatment?

Active surveillance is a major treatment option for patients with favourable prognosis prostate cancer, such as those regarded as Cambridge Prognostic Group (CPG) 1 and 2 [1]. The rationale for this management strategy is the lack of survival benefit from...

Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

The postcode lottery costing men with prostate cancer years of life

Nearly a third of men miss out on lifesaving treatments for prostate cancer – raising to more than half in worst-hit areas Prostate cancer can be cured if found early, but 31% of men diagnosed with aggressive but curable prostate...

PSA screening in limbo: how low should we go?

One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...

Defining adjuvant, consolidative, and salvage treatment after RP

The most common oncologic outcome following radical prostatectomy (RP) for localised prostate cancer is achieving undetectable prostate-specific antigen (PSA) levels (<0.1 ng/ml), indicating an absence of detectable disease. However, the landscape of RP is shifting as active surveillance becomes the...

Clinical Trials 2 – key papers

Clinical Trials 1 is available here. Case 1 This British study on haematuria clinic diagnostic yield was published in the British Journal of Urology International in 2006. The results are often asked in examinations! Edwards TJ, et al. A prospective...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

Prostate cancer management 1 – non-metastatic disease

You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...

Artificial penile pearls: what every Urologist should know!

Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...