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Prostate abscess

Prostate abscess (PA) is a relatively uncommon clinical condition which is often difficult to diagnose because clinical symptoms are non-specific. It may be associated with a significant fatality rate, estimated to be between 3% and 30%, which may reflect its...

History of prostate biopsy – part 1

Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...

Assessment and management of percutaneous nephrostomies

Nephrostomies are a valuable uroradiological intervention which enables drainage of the obstructed kidney, amongst other indications. Complications associated with nephrostomies following placement are not uncommon, with re-presentation to the emergency department or surgical emergency unit. In this review we will...

CRP to predict the need for surgical intervention in acute renal colic

A previous paper has suggested that C-reactive protein (CRP) is a useful serum marker for determining the likelihood of a patient with renal colic requiring surgical intervention, the cut-off level being >28mg/l (specificity 88.9%, sensitivity 75.8%). This prospective observational study...

A practical guide to success in National Selection

Gidon Ellis and Jonathan Makanjuola were both selected at National Selection in 2012 for Urological Higher Surgical Training. Both were ranked first in their respective interview rounds that year. It is no mean feat. Having read their article – their...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Introduction to prostate cryotherapy

Introduction Cryotherapy was first described by Dr James Arnott in 1850 where he used crushed ice and salt to get temperatures as low as -24oC, in the treatment of cervical and breast tumours [1]. The literature on prostatic cryotherapy dates...

Challenges in urology during and after the COVID-19 pandemic: a trainee perspective

The COVID-19 pandemic has affected urological practice in many ways and at all levels. Social media has been set alight with the hashtag #NoTrainingTodayNoSurgeonsTomorrow highlighting the undesired consequences of the reduction in training opportunities. The impact has been considered by...

Is silodosin the new first-line treatment for LUTS secondary to BPH?

This meta-analysis aims to evaluate the safety profile and non-inferiority of silodosin when compared to tamsulosin for the treatment of male lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). As the prostate and bladder neck are abound...

Who should be taking care of the adolescent with testicular torsion?

From time to time (as paediatric surgeons), we receive referrals from regional hospitals to explore the testis in older boys. Given the time-critical nature of the condition, patients should benefit from assessment and surgery performed locally (when possible). Inter-hospital transfer...

Planning and doing a fellowship: advice during the COVID-19 era

To paraphrase Shakespeare, to do, or not to do a fellowship, that is the question. That may be your question; whether or not to pursue a fellowship, even more so due to the uncertainty of the COVID-19 pandemic. There are...

A guide for the assessment and management of post-obstructive diuresis

Acute urinary retention is a common condition encountered in the emergency situation and is initially managed by urethral catheterisation. This is often performed by nursing staff or junior doctors. Post-obstructive diuresis (POD) is a specific entity which may occur post...