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Nuptial night tragedy

Case 1 A fit and well 50-year-old gentleman presents to the emergency department with pain and swelling of his penis that started a few hours after he had a shower earlier in the day. On examination, the appearance is as...

Renal masses

Case 1 A 70-year-old female presented under the medical team with malaise, weight loss, and deranged liver function tests (LFTs) and calcium (ALP 350, GGT 650, Serum bilirubin 29, normal aminotransferases, Ca 3.3). An abdominal ultrasound scan (USS) was performed...

Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

Prostate cancer

Case 1 A 65-year-old man is referred to your two-week wait (2WW) clinic with a PSA of 7.0ng/mL. He has no lower urinary tract symptoms (LUTS), no past medical history, no family history of prostate cancer (PCa) and his performance...

Infections and inflammation: Part 3

See also Part 1 and Part 2 Case 1 You review a man in the Emergency Department with scrotal pain and sepsis. His clinical examination findings are shown. What does this image show? Who was this condition named after? What...

Infections and inflammation: Part 2

See also Part 1 and Part 3. Case 1 A 43-year-old lady presented to the urologist with a history of pain during bladder filling and associated frequency / urgency. She underwent standard microbiological and radiological investigations that are normal. She...

Infections and inflammation: Part 1

See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...

I wasn’t expecting that! A series of unexpected radiology findings

Case 1 A 76-year-old diabetic man with a long-term catheter presents to the Emergency Department with rigors and non-specific abdominal pain. He has an elevated white cell count (WCC) and C-reactive protein (CRP). An abdominal and pelvic CT scan was...

Nephrocalcinosis

Case 1 What does this x-ray of the kidney, ureter and bladder (KUB) show? What are the likely causes? What is the pathology behind medullary sponge kidneys (MSK)? What is the risk of urolithiasis with MSK? How are such patients...

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...

Retroperitoneal sepsis

Case 1 An 80-year-old woman presented with history of recurrent and recent cystitis, low grade pyrexia, abdominal and back pain, and pain on movement of the left hip which was observed to be flexed and externally rotated. What is the...

Testicular cancer (Jan 2016)

Case 1 A 26-year-old male presented with a two-week history of testicular pain and swelling. On examination the right testicle was enlarged, indurated and tender. Erythema of the scrotum on that side was also noted. Ultrasound of the testis reported...