Liver cystic echinococcosis (CE), known as hydatid disease, is caused by the tapeworm Echinococcus granulosus sensu lato. Humans are accidental hosts in this zoonotic disease process, and hepatic infection accounts for over two-thirds of all cases. Since signs and symptoms are mainly non-specific, especially in early disease, clinicians should have a low threshold to include CE as a differential diagnosis in patients with positive serology and suggestive radiological findings, especially in endemic regions. The standard management for liver CE depends on the patient’s symptoms, the radiological stage, the size and location of the cyst, the presence of complications and the treating clinicians’ expertise. In this review, we discuss the lifecycle of Echinococcus granulosus sensu lato and its epidemiology and then focus on discussing the clinical features, diagnosis and treatment options of CE of the liver.

To review the latest evidence on the complications of elevated intrarenal pressures (IRPs) in retrograde intrarenal surgery (RIRS) and the strategies to mitigate the increase of IRP during surgery. A literature search of the PubMed, MEDLINE, and Google Scholar databases was conducted from inception to April 2024. The analysis involved a narrative review. Normal physiological IRP in an unobstructed kidney ranges from 0 to 15 mmHg (0-20 cmH2O). During RIRS, dangerous IRPs are often reached, resulting in complications. These include pyelorenal reflux, which predisposes the patient to fever, urosepsis and postoperative pain, and forniceal rupture, which may result in intraoperative bleeding as well as acute kidney injury, post-operative pain and fluid overload. To maintain safe IRP, outflow should be as close as possible to inflow. Minimising the irrigation pressure by controlling the flow rate, reducing the pressure of the irrigant fluid, using a ureteral access sheath and maintaining an empty bladder during the procedure and, more recently, using real-time intrarenal pressure monitoring are appropriate techniques to mitigate unsafe IRPs. Several complications from RIRS are related to elevated IRPs. Urologists need to understand the concept of IRP in endourology, the dangers associated with an elevated IRP, and the techniques that may be used to mitigate unsafe IRPs.

Prostate cancer (PCa) is one of the most commonly diagnosed cancers among men, with a rising global incidence. Currently, the PCa landscape is vastly different between developed countries and Africa. Of note, owing to various biological, socioeconomic and institutional factors, black African men often present with more advanced disease and suffer greater mortality. This review will focus on the burden of PCa globally and in Africa, compare the state of the disease in Africa with that in more developed regions of the world, and answer the question why it can sometimes look like a ‘different’ disease compared with developed regions. In addition, we address the racial disparities of PCa.

Urethral polyembolokoilamania, the self-insertion of a foreign body into the male urethra for sexual gratification and autoerotism, is an uncommon urological emergency with potentially severe consequences. We present the case of a 27-year-old male who presented to our emergency unit after apparently sustaining a penile injury during sexual intercourse. Clinically, a foreign body was thought to be palpable, extending from the mid-shaft of the penis to the penoscrotal junction. Pelvic X-rays confirmed a radiopaque penile foreign body in the region of the anterior urethra. Cystoscopy confirmed the presence of an encrusted foreign body in the anterior urethra. It noted that the surrounding mucosa was very inflamed with areas of necrosis, suggesting that the foreign body had been present in the urethra for some time. To avoid further urethral trauma, we approached the foreign body via an external urethrotomy and removed a plastic knife in three parts. The urethra was repaired over a 16F catheter. The patient had an uneventful postoperative course, and a peri-catheter urethrogram 6 weeks after the procedure showed no signs of contrast extravasation or urethral stricture.

Prostate cancer (PCa) is the most widespread solid organ malignancy in males and ranks as the fifth leading cause of death globally. Identifying and treating men with clinically significant disease while avoiding the over-diagnosis and over-treatment of indolent disease remains a significant challenge. Several professional associations have developed guidelines on screening and early diagnosis of asymptomatic men with prostate-specific antigen testing. With recent updates from several large randomised prospective trials, the South African Urological Association and the Prostate Cancer Foundation of South Africa have developed these evidence-based recommendations to guide clinicians on PCa screening and early diagnosis for South African men.

TFE3-rearranged renal cell carcinoma (RCC) is a rare but well characterised histological subtype of RCC with an aggressive clinical course and propensity for late metastases. Osseous metaplasia is an uncommon but well documented finding in clear cell, papillary and chromophobe RCC. We present the first case of a TFE3-rearranged RCC to be found harbouring metaplastic bone in a 47-year-old woman who presented with a slowly enlarging left flank mass over a 10 year period. This case report adds to the clinicopathological description of TFE3-rearranged RCC and suggests that larger studies are required to fully elucidate the prognosis of these tumours.