Abstract. Ileal conduit urinary diversion is the gold standard treatment for urinary tract reconstruction following cystectomy. This procedure uses gastrointestinal segments for bladder augmentation, a technique that is often associated with significant complications. The substantial progression in the fields of tissue engineering and regenerative medicine over the previous two decades has resulted in the development of techniques that may lead to the construction of functional de novo urinary bladder substitutes. The present review identifies and discusses the complications associated with current treatment options post-cystectomy. The current techniques, achievements and perspectives of the use of biomaterials and stem cells in the field of urinary bladder reconstruction are also reviewed.

Multilocular cystic nephroma is an uncommon benign entity grouped among the cystic non-genetic diseases. It is characterized by variable-sized, non-communicating cysts separated by irregular thin walled septa. Though multilocular cystic nephroma is usually considered a benign lesion, malignant changes in the cysts should not be overlooked.

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Ultrasound phantoms are very helpful in allowing the trainee to develop the necessary manual coordination skills before attempting any procedure on patients and compromising their safety. The construction of agar-based trans-rectal ultrasound prostatic biopsy phantom, using inexpensive and simple materials, is described. Features include tissue-equivalent reflectivity, the ability to implant targets for biopsy taking and reasonable shelf life of several weeks. Our phantom is an effective mean of training and skill acquisition for a one of the frequently performed invasive urological procedure.

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We read with interest the recent publication by Jones et al.: Paratesticular leiomyosarcoma: a case report and review of the literature. 1 A case is presented of a 47-year-old man who presented with a painless hemiscrotal mass that had been present for 3 years. The diagnostic work-up and histological confirmation of leiomyosarcoma is described. The authors stress that the patient underwent an initial transscrotal excision followed by radical orchidectomy including scar excision following sarcoma multidisciplinary team discussion. The rarity of paratesticular tumours is discussed and the authors highlight sarcomas (rhabdomyosarcoma, leiomyosarcoma and liposarcoma) as accounting for 90% of these lesions, with radical orchidectomy remaining the standard treatment. The authors should acknowledge that treatment of paratesticular myxoid liposarcoma, accounting for a third of paratesticular liposarcomas, with testis preservation alone, has been described by McGuinness et al. 2 The two cases share some similarities; both presented with a long history of scrotal swelling prior to presentation, tumour markers were negative in both cases and spindle cell morphology was noted. However, the treatment modalities differ as the case described by Jones et al. underwent two surgical procedures with no recurrence detected at 3 months. 1 McGuinness et al. performed scrotal excision only in a 27-year-old patient with testis preservation with no recurrence noted at 5 years postoperatively. 2 Although usually detected in middle-aged men, additional reports do exist of paratesticular myxoid liposarcomas occurring in younger men treated with orchidectomy and neoadjuvant chemotherapy. 3 Therefore, although radical orchidectomy is the accepted method of treatment for paratesticular sarcoma, testis preservation has been successfully recorded.

Objective: COVID-19 resulted in Regional tiered restrictions being introduced across the UK with subsequent implications for planned and emergency surgical care. Specific to Merseyside, Tier 4, Tier 2 and Tier 5 restrictions were introduced in late 2020 and early 2021. The purpose of this study was to examine the nature and workload of emergency urological procedures during three different national lockdown Tiers in the North West of England. Method: A 3-month prospective study examining all emergency urological activity was conducted from November 2020 when Tier 4 restrictions were introduced and included Tier 2 restrictions in December and then concluded at the end of January 2021 when Tier 5 restrictions were in place. Data was obtained by identifying patients using the electronic theatre listing system. Results: A total of 71 emergency cases were performed (24 in November (Tier 4), 28 in December (Tier 2), 19 in January 2021 (Tier 5)) with 15 different types of procedures performed. The most frequently performed procedure was stent insertion (36), followed by scrotal exploration (10). The least commonly performed procedure was suprapubic catheter insertion under general anaesthesia (1). One patient required transfer to a different hospital. In total 6 calls were made by general surgery and 3 by gynaecology for urgent urological assistance in theatre. Three urology patients returned to the theatre as emergencies following elective procedures. Conclusion: Unlike the Spring lockdown, acute urological presentations requiring operative intervention still presented daily. Of the 71 cases performed, most occurred in Tier 2. Stent insertion was the most commonly performed procedure, with the majority of the cases performed by registrars.