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Focal therapies in prostate cancer

The standard of care in the management of prostate cancer has, to date, always been to treat the whole gland. This has ranged from surveillance, surgical excision / prostatectomy or external beam radiotherapy / whole gland brachytherapy. With the evolution...

Demanding cases or nightmares in uro-oncology? Sep/Oct 2022

Treatment of prostate cancer in renal transplant recipients is challenging due to a lack of knowledge of the natural history of cancer in these patients, the anatomical position of the graft in the iliac fossa and its proximity to the...

Innovations in urology – OOPE for trainees

“Innovation is the ability to see change as an opportunity – not a threat” – Steve Jobs [1] The world is changing rapidly. Healthcare has seen a fast reform, especially as a consequence of COVID-19. Urology is a rapidly evolving...

Seminal vesicle calculi

Epidemiology Seminal vesicle calculi are uncommon with just over 100 cases being reported in the literature, although the true incidence is likely to be higher [1-9]. Patients usually present aged between 30 and 45 years old and although the pathogenesis...

Adrenal incidentalomas: what next?

An incidentaloma refers to an adrenal lesion >1cm discovered incidentally during radiologic examination. Identifying a malignant and / or functioning lesion is critical for management. However, as the majority of lesions are benign, the challenge is the identification of malignant...

An update on erectile dysfunction guidelines and treatment options

Erectile dysfunction is defined as the persistent inability to attain and / or maintain an erection sufficient for sexual performance. Not only does this have a psychosocial impact, it also affects the quality of life of both the patients and...

Sarcomatoid renal cell carcinoma

Renal cell carcinoma (RCC) represents 2-3% of all cancers [1]. It is an adenocarcinoma making up 85% of all renal malignancies. Sarcomatoid transformation is a microscopically identified feature of RCC accounting for 5% of all RCCs [2]. Known as sarcomatoid...

Testicular cancer: management of stage I seminoma

Introduction Testicular cancer is the most frequently occurring solid tumour in men between the ages of 15 and 34 years [1]. About 60% of cases are seminomas and approximately 70-80% of them have, at presentation, clinical stage I disease. This...

Image-guided renal cryoablation

Introduction There has undoubtedly been a dramatic increase in the number of patients diagnosed with small renal masses in recent years [1]. The rapidly expanding use of CT has led to a large number of incidental diagnoses, but increasing longevity...

Shared decision-making – minimising the mismatch

In Western countries, we are spoilt for choice in almost every aspect of our lives, but does that reflect also in healthcare? While we have taken some big strides towards shared decision-making with our patients, the age-old physician dominance remains...

Burnout: an increasing problem in urology

“What we mean, man,” said Chuck forcefully, “is this: how can we care for patients if nobody cares for us?” – Samuel Shem, The House of God, 1978. Samuel Shem’s (Steven Bergman, MD) satirical novel The House of God, has...

Using cryopreserved prepubertal testis tissues – are we getting warmer?

The rising incidence of childhood cancer coupled with increasing survivorship means there is a growing population of childhood cancer survivors with unmet health needs. In the UK around 1 in 500 children and young people are survivors of childhood cancer....