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Transplant urology at Guy’s Hospital: making the most of a year out before specialty training

It was gutting to miss out on urology at national selection on my first attempt. The ST3 application has become increasingly competitive and this means more appointable trainees find themselves looking to plan B. The options available can be daunting...

Burnout in surgery

When I was pregnant with my first child, I went to a talk on how to achieve work-life balance and avoid burnout. It was given by a highly respected Australian surgeon and I was eager to hear the secrets that...

Does maternal exposure during pregnancy to higher ambient temperature increase the risk of hypospadias?

The search for the causes of hypospadias continues at a pace. These authors from Turkey extrapolated other findings about the higher incidence of congenital anomalies in babies during summer months’ gestation to studying the risks of high ambient temperature during...

Demanding cases or nightmares in endourology? Jan/Feb 2017

In the fifth article in this series the authors describe some of the most complex cases they have encountered. Case 1 A 45-year-old woman was admitted under the care of the medical team with shortness of breath, renal failure and...

Prostatic artery embolisation versus sham

Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...

Low dose PDE5I in IC

This is a randomised, double-blind, placebo-controlled trial to evaluate the efficacy of daily low-dose sildenafil (25mg) for the treatment of non-ulcer interstitial cystitis (IC) in women. Forty-eight women with clinical diagnosis of IC, from three centres, were equally randomised to...

Use of Clavien-Dindo classification in urology part 2 – upper tract

A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...

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...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...

Keeping your eye on the ball: atypical presentations of testicular malignancy

Most testicular cancers present with a painless lump on the testes, and most are confidently diagnosed on examination and ultrasound. They have an excellent prognosis, with 90% patients alive at 10 years [1]. However, advanced testicular cancer, or those with...

Reflux oesophagitis and risk of interstitial cystitis: is there a link?

This study aims to explore the potential link between reflux oesophagitis (RE) and interstitial cystitis / bladder pain syndrome (IC/BPS). IC/BPS is a chronic disease which is difficult to diagnose and treat. Two percent of the population may be affected....

Prostate cancer survivorship: a new path for uro-oncology

Over two million people in England have a diagnosis of cancer [1]. Of this figure, over 250,000 have been diagnosed with prostate cancer [2]. However, during the next decade, a rapid increase in the number of new cancer diagnoses, as...