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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...

Erectile dysfunction part II: treatment

Introduction The identification of specific risk factors associated with erectile dysfunction (ED) allows patients with mild or moderate ED to undergo a series of lifestyle changes, which may provide enough improvement in the erectile function to avoid pharmacotherapies. Cessation of...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...

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...

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...

Demanding cases or nightmares in uro-oncology? Jan/Feb 2023

Radical surgical treatment of prostate cancer has become minimally invasive owing to robotic assisted laparoscopic technology [1]. Patients who undergo robotic assisted radical prostatectomy (RARP) often have lower risk of morbidity compared to an open approach. However, patients with a...

An old resectoscope in a wooden case

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last article I said I would write about a particular artefact...

Complications of CISC

Introduction Clean intermittent self catheterisation (CISC) was first introduced and popularised by Lapides in 1972. Since then its utilisation has become widespread and it is now commonly used throughout the world as the preferred means of facilitating complete and effective...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...

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...

Sustainable healthcare: what steps can urologists take?

Human health is intrinsically linked to environmental health, making the ever-pressing climate crisis fundamentally a public health emergency. The healthcare sector is responsible for 8% of the UK’s greenhouse gas (GHG) emissions worldwide [1]. As the largest publicly funded healthcare...

Suprapubic catheterisation – a core surgical trainee’s perspective

Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...