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Online urology teaching

The COVID-19 crisis continues to disrupt our traditional models of teaching. Urological emergencies account for 20% of all acute surgical admissions and 5-10% of general practitioner visits [1]. Currently in the UK, undergraduate teaching on urology is not compulsory. Fewer...

The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

A review of the diagnosis and management of urethral caruncles

Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...

Inpatient care of patients with established spinal cord injury - what a general urologist needs to know

Introduction Spinal cord injury (SCI) is a devastating, life-changing condition, which is currently irreversible. Depending on the level of the spinal cord affected (and whether the lesion is complete or incomplete), patients may subsequently develop reduced voluntary motor function, sensory...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...

Preoperative use of testosterone prior to distal hypospadias repair

Preoperative hormonal stimulation has been utilised for >50 years in hypospadias surgery. Surgeons utilise testosterone (T) to increase penile size and glans width to try and improve clinical outcomes. However, a paucity of reliable data supporting its use has limited...

Urological trauma – part 1

Part 2 of this topic is available here. Case 1 A 45-year-old male presented with acute onset abdominal pain following a fall whilst out drinking. A CT cystogram was arranged as he developed haematuria and acute renal impairment. 1. What...

Endoscopic management of upper tract urothelial carcinoma

Upper tract urothelial carcinoma (UTUC) is a rare disease accounting for 5-10% of all urothelial carcinomas and has an annual incidence in Western countries of 1-2 per 100,000 [1,2]. It occurs more commonly in the pelvicalyceal system as opposed to...

The adrenals

Case 1 A 45-year-old man undergoes a CT of his abdomen to stage a newly diagnosed bowel malignancy. What does the scan show? What findings on a CT scan suggest an adrenal lesion is benign? If the CT scan is...

Prostate cancer nurse specialist shortage: a view from the coal face

Prostate Cancer UK recently reported that there is an impending crisis for men with prostate cancer, simply because the number of nurse specialists available is insufficient for their needs [1]. Background As has been widely reported, the incidence of prostate...

New ultrasound imaging technique reliably spots prostate cancer, initial patient trial reveals

A groundbreaking new imaging approach developed by researchers at Heriot-Watt University has shown ‘extremely encouraging’ results in early-stage clinical trials on prostate cancer at the Western General Hospital in Edinburgh, Scotland. The ongoing clinical trial demonstrated an initial 94% sensitivity...

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...