About

This online course is aimed at Core Surgical Trainees who regularly encounter urology patients during on-calls, emergency admissions and peri-operative cross-cover. It builds on the basic principles expected at foundation level and focuses on the more advanced decision-making, cancer pathways and operative reasoning needed for CST practice and MRCS preparation. The session begins with haematuria, comparing outpatient and inpatient pathways, clarifying two-week-wait criteria and summarising appropriate investigations for suspected upper and lower tract malignancy. Ureteric obstruction is then explored in more depth, covering stones, tumours and external compression from pelvic or retroperitoneal disease, with discussion of when stents or nephrostomies are appropriate and the principles of stent insertion.

The later part of the course focuses on time-critical emergencies. Testicular torsion is approached from both a pre-operative and intra-operative angle, including counselling, consent points and stepwise scrotal exploration. Penile emergencies such as priapism and penile fracture are covered with emphasis on safe early management and when urgent theatre is needed. The course concludes with Fournier’s gangrene, outlining initial assessment, resuscitation and early surgical priorities. The overall aim is to prepare CSTs for confident frontline management while strengthening the applied knowledge needed for the MRCS.

Aims

• Provide CSTs with an advanced, clinically relevant understanding of common urological emergencies and cancer pathways encountered in acute and elective practice.
• Strengthen decision-making around haematuria, including appropriate investigations, 2WW referrals and inpatient admission criteria.
• Develop confidence in assessing ureteric obstruction from stones, malignancy or external compression, and understanding the indications for stents and nephrostomies.
• Enhance knowledge of operative and peri-operative management of testicular torsion, including principles of scrotal exploration.
• Improve early recognition and management of penile emergencies and Fournier’s gangrene, with emphasis on safe initial steps and timely escalation.

Learning Outcomes

• distinguish between haematuria presentations suitable for outpatient work-up and those requiring inpatient admission, and outline appropriate investigations for suspected urological cancers.
• assess ureteric obstruction caused by stones, malignancy or external compression, and explain the indications for stent insertion versus nephrostomy.
• describe the key stages in pre-operative assessment and intra-operative management of testicular torsion, including the steps of scrotal exploration.
• recognise and manage penile emergencies such as priapism and penile fracture, and identify when immediate surgical intervention is needed.
• conduct an early assessment of Fournier’s gangrene, initiate resuscitation and broad-spectrum antibiotics, and arrange prompt surgical debridement.

Aimed at:

• Foundation Year 1
• Foundation Year 2
• Core Surgical Trainee 1
• Core Surgical Trainee 2
• Trust Grade
• Junior Research Fellow
• Clinical Research Fellow
• Speciality Registrar