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Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

An algorithm for the management of haemorrhagic cystitis

Haemorrhagic cystitis (HC) can be one of the most difficult conditions to treat in urological practice. It is characterised by intractable bleeding from the bladder and may be acute or chronic. The most frequently reported causal factors are radiotherapy (RT)...

Bladder cancer: where are we with intravesical therapies?

In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...

Stereotactic body radiotherapy for oligometastatic disease secondary to urological cancer

The concept of oligometastatic disease is controversial. The traditional model of cancer, which most of us learnt at medical school, is of a disease which starts confined to an organ, for example the prostate, where it can be cured with...

Delivering a laparoscopic urology workshop in West Africa: our initial experience in Senegal

Despite universal adoption and significant technological innovation since its inception around 30 years ago, access to laparoscopic surgery remains lacking in Sub-Saharan Africa (SSA). Whilst some progress has been made in recent years to bridge the gap with the developed...

The expanding indications for ureteroscopy – ad maiora!

The management of urolithiasis is becoming a Herculean task for healthcare providers worldwide. The incidence of stone disease is rising, with predicted lifetime risk of 12% in males and 6% in females [1]. This rise relates to both improving imaging...

Use of Clavien-Dindo classification in urology part 1 – pelvic surgery

There is no widely accepted system to classify postoperative complications. It is necessary to compare the outcome and complications while validating a new surgical procedure or one of the surgical approaches of a particular condition. Several parameters have long been...

The role of an enhanced recovery protocol in patients undergoing robotic radical cystectomy

Enhanced recovery after surgery (ERAS) protocols are patient pathways designed to reduce surgical stress and accelerate postoperative recovery. Uptake of such protocols in colorectal surgery in particular has been high, however ERAS protocols developed or utilised in urological surgery have...

Cutting-edge or over-hyped? Evaluating the role of robotic surgery in the management of renal cell carcinoma

The quest for a minimally-invasive approach to major abdominal surgery finds its roots at the start of the previous century, when Georg Kelling first described the technique of ‘ceolioscopy’ to inspect intraabdominal organs in 1901 [1]. Since those early days,...

Priapism in sickle cell disease

What is sickle cell disease? Sickle cell disease (SCD) is one of the most common single-gene disorders in the UK affecting approximately one in every 2000 live births. Approximately 20-25 million people worldwide have SCD. It predominately affects those of...