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Conservative management of pelviureteric junction

Background Pelviureteric junction obstruction (PUJO) is defined as a functionally significant impairment of urine flow from the renal pelvis into the proximal ureter. For more than a century, surgery was considered the first-choice approach to management. However, the widespread use...

Artificial penile pearls: what every Urologist should know!

Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...

Optimising weight loss advice in obese women with urinary incontinence: a review

Background The National Institute for Health & Care Excellence (NICE) guidance specifies that women with a body mass index (BMI) of over 30, combined with urinary incontinence or overactive bladder, should be advised to lose weight [1]. A BMI over...

Testing radical prostatectomy in men with prostate cancer and oligometastases to the bone: a randomised controlled feasibility study

Prostate cancer is the commonest cancer and the second most frequent cause of cancer death in Western men [1]. The recent STAMPEDE data suggests a median survival of just 42.1 months in the control arm of metastatic men [2]. Current...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...

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...

Supporting return to clinical practice

There are many reasons for a clinician to take time away from clinical practice. These include parental leave, research, a period of ill health, a career break, or the opportunity to spend time pursuing other interests. At any one time,...

HIV / AIDS – implications for the urologist

“It’s no fun to have HIV even though it’s viewed as a chronic, controllable disease. It means being wedded to the health system.” - Philip Berger, Associate Professor in the Department of Family and Community Medicine, Toronto, Canada; and leading...

Emphysematous pyelonephritis: a review

Introduction Emphysematous pyelonephritis (EPN) is an acute, severe, necrotising, bacterial infection of the renal parenchyma and surrounding tissues, with gas in the renal parenchyma, collecting system or perinephric tissue. Although it is rare, it is potentially life threatening and early...

Metastatic spinal cord compression – a review

Introduction Metastatic spinal cord compression (MSCC) is an oncological emergency that, unless diagnosed early and treated appropriately, can lead to significant morbidity and mortality, including paralysis and bladder and bowel dysfunction. MSCC can be defined as spinal cord or cauda...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

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...