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Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...

EBM Stats Calc: there’s a stat for that

Quantifying the value of a specific test or intervention for a patient is no easy feat. Even when the value of a given test or intervention has been established, there may be additional case-specific factors to consider that are not...

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...

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 ‘survival guide’ to an ST3 year in urology

Following success in national selection, it soon dawns on the successful candidate that entry into higher surgical training (HST) requires more than a little clinical knowledge. The role requires administrative and organisational skills not hitherto called upon. This additional skill...

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)...

Improving on the Rotterdam Prostate Cancer Risk Calculator

Following the PROMIS trial [1], many cancer centres in the UK are now offering pre-biopsy multiparametric MRI (mpMRI) for men suitable for radical treatment. The European Association of Urology for Prostate Cancer (PCa) guidelines recommend individual risk stratification before the...

Technology for remote working and COVID-19 resources

The COVID-19 pandemic has altered every aspect of how we live, and how healthcare needs to be provided for the welfare of patients and staff. I thought I would try to summarise a few potential technology tools that could be...

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...

Cystoplasty

Case 1 A 48-year-old female, having previously had an augmentation ileocystoplasty 10 years ago, has been referred with right loin pain by the emergency department. A venous blood gas is performed shortly after triage with the following values: What is...

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...

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...