Prostate cancer mortality in the Caribbean region is among the highest in the world and prostate cancer is the most common cancer in Trinidad and Tobago. There is a two-tiered healthcare system in Trinidad and Tobago, and prostate cancer related issues account for a significant percentage of urologists’ workload. Delivery of care is sometimes constrained by limited financial resources. Prostate-specific antigen testing is widely available but there is no national guideline. Treatment options available include active surveillance, radical prostatectomy, external beam radiotherapy and brachytherapy. Patients have access to androgen deprivation, chemotherapy and palliative care for the management of advanced disease. Generally, the infrastructure for treatment in Trinidad and Tobago is satisfactory but would benefit from further investments in technology and human resources.

This is the largest series of urethral CIS, a disease with potentially serious consequences. A high index of suspicion should be maintained when evaluating and managing these patients.

Fracture of the penis is not uncommon and usually occurs during intercourse when the erect penis forcefully hits against the perineum or symphysis pubis. The aetiology varies with geographical area, and additionally penile self-manipulation is more common in the Middle East. While imaging may be used as an adjunct to aid diagnosis, especially in equivocal cases, it remains largely a clinical diagnosis. Immediate repair has been established as the standard of care although delayed repair has also been employed with equally successful outcomes. The degloving incision facilitates very good exposure but repair may be undertaken via a simple direct incision if the fracture site can be localised. Urethral injuries usually require repair, although successful non-operative management of small partial tears has been described. Postoperative medications to suppress erections have not been of proven benefit.