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The Lester Eshleman Urology Workshop (Tanzania): a trainee’s perspective

For many trainees a period abroad is increasingly an essential supplement to higher surgical training in the UK. However, for many, because of family responsibilities or financial imperatives, this is not always a viable option. There are however alternatives. Here...

Does empowering men on active surveillance for prostate cancer improve patient compliance and reduce conversion to treatment?

Active surveillance is a major treatment option for patients with favourable prognosis prostate cancer, such as those regarded as Cambridge Prognostic Group (CPG) 1 and 2 [1]. The rationale for this management strategy is the lack of survival benefit from...

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...

Renal calculi: the role of imaging in pregnancy

Nephrolithiasis is the most common cause of non-obstetric abdominal pain in pregnancy. Accurate diagnosis is imperative as stone related complications can lead to pre-eclampsia, urosepsis, and premature labour [1,2]. In the general population, non-contrast cross sectional imaging is recommended by...

Fournier’s gangrene

Introduction Fournier’s gangrene (FG) is a rare but fulminant form of infective necrotising fasciitis affecting the perineum and external genitalia, which can rapidly progress along fascial planes. It most commonly affects men, but can occur in women and children, with...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Thulium laser: the new kid ‘en bloc’

Transurethral resection of bladder tumour (TURBT) is considered the gold standard for management of bladder cancer. Residual rates of 15-53% at second TURB and upstaging rates of 4-29% with muscle invasion have been reported. The quality and result of the...

Prostate cancer now England’s most common cancer

Prostate cancer cases overtook those of breast cancer by thousands in both 2022 and 2023, according to Prostate Cancer UK analysis of NHS data. Huge increase shows that more men than ever before are learning about their risk and taking...

Missed Meyer-Weigert duplex ureter during emergency ureteric stenting for ureteric stones

The Meyer-Weigert rule is a fundamental anatomical principle in urology that describes the typical orientation of ureteral orifices in duplex kidneys. In a duplex system, the upper pole ureter usually inserts inferomedially, while the lower pole ureter inserts superolaterally. This...

Reflections on 20 years as an Army Reserve doctor: live a life less ordinary

It seems a very short time ago that my predecessor recruited me into my regiment as a surgical senior house officer during a varicose vein operation in a cottage hospital in Stroud, informing me that I would be only the...

LUTS update

Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...

OCERT: a new multi-specialty project to standardise robotic surgical training

Since its introduction by Dr William Osler in 1890 to the Board of Trustees at John Hopkins Hospital [1], the Halstedian ‘See one, do one, teach one’ has represented a guideline for surgeons worldwide, both for open and laparoscopic surgery,...