Renal cell carcinoma presenting as painless jaundice and unintentional weight loss.

Painless jaundice and unexplained weight loss is an exceedingly rare presentation for renal cell carcinoma (RCC). Such a presentation is more typical of a hepatocellular pathology. Stauffer syndrome is a paraneoplastic syndrome seen in RCC and is characterized by deranged hepatic enzymes and in association with fever, fatigue and weight loss.

Strategies to maximise patient comfort during extracorporeal shockwave lithotripsy - A randomised controlled trial.

Background/purpose Of Study: We aim to assess if distraction techniques improve patient comfort tolerability of SWL.

Methods: We carried out a prospective randomised controlled trial of SWL-naïve patients attending for treatment. Patients were randomised into three groups and offered oral analgesia as standard of care.

Biopsy at flexible cystoscopy: is it worthwhile?

Introduction: Flexible cystoscopy is the gold standard for diagnosis and surveillance of bladder carcinoma. Most flexible cystoscopes feature a working channel allowing for bladder biopsy and diathermy if a suspicious lesion is observed. However, the working channel permits only small instruments which limit the volume of material retrieved for histological analysis.

Is Movember synonymous with moustaches or men's health? An examination of internet search activity for prostate and testicular cancer during the campaign.

Background: The Movember campaign encourages men to grow a moustache during the month of November. The campaign's aims include promotion of prostate and testicular cancer awareness.

Aims: To examine the effectiveness of the Movember campaign at generating awareness of prostate and testicular cancers by examining Internet search activity.

Outcomes from the Introduction of a Combined Urology Outpatient Clinic.

Background: A combined urology clinic staffed by four consultants and four non-consultant hospital doctors (NCHDs) was introduced in our institution in October 2015. This clinic is supported by a pre-clinic radiology meeting and a synchronous urology clinical nurse specialist (CNS) clinic with protected uroflow/trial of void slots. Herein, we report on the outcomes of this clinic in comparison with the standard format of urology outpatient review.

Radiation dosing in the investigation and follow-up of urolithiasis: Comparison between historical and contemporary practices.

Purpose: Computed tomography (CT) is the gold standard imaging modality for the diagnosis and follow-up of urolithiasis. Before the use of CT, intravenous urography (IVU) was the imaging modality of choice. CT remains contentious because of the cancer risk related to radiation exposure above a threshold level.

Acute urinary retention and the difficult catheterization: current emergency management.

Acute urinary retention (AUR) is a common presentation to emergency departments. This article updates the reader on the appropriate management, investigations and guidelines for AUR. It looks at the mechanism of normal micturition and describes the theories of AUR.

Renal track creation for percutaneous nephrolithotomy: the history and relevance of single stage dilation.

Introduction: Percutaneous nephrolithotomy (PCNL) was described in the 1980s and revolutionized the treatment of stone disease. The crucial component to this surgery is satisfactory track creation. We examine how the development and production in the 1980s of a single stage dilator (SSD) subsequently modified for pediatric PCNL has become the ideal access tool for mini percutaneous nephrolithotomy (mPCNL) today.

Renal colic: current protocols for emergency presentations.

Flank pain caused by renal colic is a common presentation to emergency departments. This paper reviews the acute clinical assessment of these patients, outlines appropriate diagnostic strategies with labwork and imaging and updates the reader on conservative treatments, suitable choices for analgesia and indications for surgical intervention. Prompt diagnosis and appropriate treatment instituted in the Emergency Department can rapidly and effectively manage this excruciatingly painful condition.

Testicular torsion and the acute scrotum: current emergency management.

The acute scrotum is a challenging condition for the treating emergency physician requiring consideration of a number of possible diagnoses including testicular torsion. Prompt recognition of torsion and exclusion of other causes may lead to organ salvage, avoiding the devastating functional and psychological issues of testicular loss and minimizing unnecessary exploratory surgeries. This review aims to familiarize the reader with the latest management strategies for the acute scrotum, discusses key points in diagnosis and management and evaluates the strengths and drawbacks of history and clinical examination from an emergency perspective.

Paediatric sutureless circumcision--an alternative to the standard technique.

Introduction: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique.

Septic shock due to Fournier's gangrene of the scrotum.

A 57-year-old morbidly obese (160 kg) man presented with a 12 h history of severe bilateral scrotal pain and swelling. His scrotum was erythematous, with cellulitis advancing superiorly along the anterior abdominal wall. He was in septic shock.

The treatment of vesicovaginal fistula by endoscopic injection of fibrin glue.

Creation of a vesicovaginal fistula (VVF) is a complication seen in a variety of patients from prolonged labour and elective hysterectomies to advanced gynaecological malignancies. Causing distressing symptoms such as a loss of continence and vulval excoriation, conventional teaching has always advocated an open surgical approach as described by Sims in 1852. This however may not be feasible in cases of advanced malignancy or attractive to the post-operative patient.

Acute urinary retention in a young man secondary to colonic irrigation: a case report.

Introduction: Autonomic innervation of the bladder is complex and regulated by a hierarchy of mechanisms of the central nervous system. Any dysfunction in these regulatory mechanisms can lead to acute urinary retention.

Case Presentation: A 36-year-old Caucasian man presented with acute urinary retention following extensive bowel irrigation.

Dual kidney transplantation with organs from extended criteria cadaveric donors.

Purpose: The critical shortage of kidneys available for transplantation has led to alternate strategies to expand the pool. Transplantation of the 2 kidneys into a single recipient using organs suboptimal for single kidney transplantation was suggested. We assessed results in 24 grafts allocated for dual kidney transplantation vs those in a control group of 44 designated for single kidney transplantation.

Carefully selected intratesticular lesions can be safely managed with serial ultrasonography.

Objective: To evaluate a policy of conservative non-operative management for incidental, impalpable, < 1 cm, intratesticular pathology.

Patients And Methods: We retrospectively reviewed all scrotal ultrasonograms within an 8-year period to identify all radiological lesions of < 1 cm within the testis. All palpable lesions and those accompanied by elevated tumour markers or disseminated malignancy were managed surgically.

Value of frozen section analysis with suspected testicular malignancy.

Objectives: To determine whether frozen section analysis (FSA) assists safe conservative surgery for men presenting with suspected testicular tumors.

Methods: We performed a retrospective review of intraoperative testicular FSA used at a single university institution during an 11-year period. The exclusion criteria included lesions of paratesticular origin, size greater than 5 cm, and the known presence of elevated tumor markers or metastatic disease.