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Intravesical instillation of chemotherapy before radical surgery for upper UTUC

Upper urinary tract urothelial carcinoma (UTUC) is a rare but increasingly prevalent form of urothelial cancer, accounting for 5–10% of cases, with an annual incidence of two to three cases per 100,000 individuals in Western Europe. Radical nephroureterectomy (RNU) with...

Men with a susceptibility to prostate cancer: implications of ethnicity in PCa risk-prediction and diagnosis

The diagnostic and therapeutic landscapes of prostate cancer (PCa) have advanced at great pace in the past decade. However, disparities in access to care, clinical outcomes and representation in therapeutic, interventional and genomic studies continue to exist between Afro-Caribbean (AC)...

Clinical trials 1

Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...

My detour – my year without a urology NTN and bouncing back

When I saw the dreaded words “Oriel: Application not matched” pop-up on my phone my heart sank. This was my second attempt at a urology national training number (NTN), and I had put my life on hold whilst preparing for...

Selective denervation of the bladder

The treatment of refractory overactive bladder is currently limited to neuromodulation (sacral nerve stimulation or percutaneous tibial nerve stimulation) or botulinum toxin injections. Although all these options are valuable, they have their own limitations and may not be suitable for...

Guide to gaining approval for a clinical study

This article focuses on gaining approval for clinical research involving NHS patients, although the principles can be applied to other types of research. It can be quite a daunting process for the uninitiated applicant. Often it can be made less...

A guided guide to the guide wire

The use of guide wires has become a core skill utilised by urologists, especially within the field of endourology. The authors take us through the development of the guide wire and their current use in urology. The history The first...

Simulation-based training of procedural skills: application and integration of educational theories

Educational theories: how familiar are we with these theories and their application in our training? As a Simulation Fellow I have been involved in teaching specific procedural skills and running full immersion simulation sessions. This experience has exposed me to...

Management of calyceal diverticular stones using ultramini PCNL

Calyceal diverticulae are congenital smooth-walled, non-secretory urothelium-lined cavities within the renal parenchyma that communicate with calyceal fornix through a diverticular neck. They were first described by Rayer in Traitements des maladies des reins [1]. Calculi occur in approximately 9.5% to...

Nurse practitioner TRUS biopsy: training and preparation

As prostate cancer rates increase, many urology departments rely on multi-professional teams to diagnose and manage patients with prostate cancer. The aim of this article is to highlight the skills, training and preparation required for nurse practitioners to undertake trans-rectal...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...

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...