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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...

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...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Peno-scrotal extramammary Paget’s disease

Epidemiology Extramammary Paget’s disease (EMP) is a rare intraepithelial neoplasm, which is rarely invasive and has an incidence of six per million person-years as calculated by a European SEER analysis [1]. It usually affects apocrine gland-bearing areas, especially the vulvar,...

Radiological investigation of haematuria in 2016

This paper summarises the current evidence for and use of various imaging modalities for investigating haematuria. The following investigations are reviewed: Intravenous urogram (IVU) – the number of centres still using IVU is decreasing. IVU is cheaper and has less...

UTI and VUR in children with mild antenatal hydronephrosis

This paper describes a retrospective analysis of 760 (608 males, 162 females) patients identified with mild antenatal hydronephrosis (defined by an anteroposterior (AP) pelvic diameter of 7-10mm in the third trimester and persistent postnatal dilation) looking at the incidence of...

Surgical video – part 1: intraoperative video recording and storage

The use of digital technology has progressed in leaps and bounds and nowhere is this more apparent than in medicine and surgery. Footage of live surgery is now easily accessed on the internet or displayed at conferences. Thus, the 21st...

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...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Bladder outlet obstruction

Case 1 Define the zonal anatomy of the prostate: A, B and C What is the significance of Zone A and Zone C? Clasify the types of lower urinary tract symptoms (LUTS) Which investigations should be routinely undertaken for a...

Partial segmental thrombosis of the corpus cavernosum

Epidemiology Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare condition and usually presents in young men. Approximately 56 cases have been reported in 34 publications since 1976, when the first two cases were described [1,2]. The mean...

MRI of the Prostate: A Practical Approach

The MRI is a non-negotiable part of prostate cancer diagnosis and management. As a result, this book is an essential. This nicely illustrated and well written account covers aspects ranging from MRI protocols, through Prostate Imaging Reporting and Data System...