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Sustainable healthcare: what steps can urologists take?
Human health is intrinsically linked to environmental health, making the ever-pressing climate crisis fundamentally a public health emergency. The healthcare sector is responsible for 8% of the UK’s greenhouse gas (GHG) emissions worldwide [1]. As the largest publicly funded healthcare...The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy
Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...Frailty in urology – part 1
Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...Demanding cases or nightmares in uro-oncology? Jan/Feb 2023
Radical surgical treatment of prostate cancer has become minimally invasive owing to robotic assisted laparoscopic technology [1]. Patients who undergo robotic assisted radical prostatectomy (RARP) often have lower risk of morbidity compared to an open approach. However, patients with a...
Beware of the ambiguous testicular lump
In busy day-to-day practice, we are often faced with puzzling situations. A useful mnemonic is 4-T: torsion, trauma, tumour and tuberculosis (infections). This case review in the BMJ is about a 34-year-old man presenting to A&E with left testicular pain...
Repeat transurethral resection in non-muscle invasive bladder cancer
The authors felt this is a big problem because there is no standardised practice on re-resection following initial transurethral resection of bladder tumour (TURBT). Getting detrusor muscle in the first specimen is thought to be important. However muscle is not...
PSM increases risk of recurrence after PN for high-risk renal tumours
Positive surgical margins (PSM) for solid organ malignancies are associated with adverse oncological outcomes. However, for RCC the prognostic significance of PSM after partial nephrectomies (PN) remains a matter of debate. As PN is more increasingly being used to excise...
