OBJECTIVE To report the short‐ to intermediate‐term experience of using salvage targeted cryoablation of the prostate (TCAP) for the recurrence of localized prostate cancer after radiotherapy. PATIENTS AND METHODS Between May 2000 and November 2005, 100 patients had salvage TCAP for recurrent prostate cancer after radiotherapy; the mean follow‐up was 33.5 months. All patients had biopsy‐confirmed recurrent prostate cancer. Biochemical recurrence‐free survival (BRFS) was defined using a prostate specific antigen (PSA) level of <0.5 ng/mL and by applying the American Society for Therapeutic Radiology and Oncology (ASTRO) definition for biochemical failure. Patients were stratified into three risk groups, i.e. high‐risk (68 men), intermediate‐risk (20) and low‐risk (12). RESULTS There were no operative or cancer‐related deaths; the 5‐year actuarial BRFS was 73%, 45% and 11% for the low‐, intermediate‐ and high‐risk groups, respectively. Complications included incontinence (13%), erectile dysfunction (86%), lower urinary tract symptoms (16%), prolonged perineal pain (4%), urinary retention (2%), and recto‐urethral fistula (1%). CONCLUSION Salvage TCAP is a safe and effective treatment for localized prostate cancer recurrence after radiotherapy.

OBJECTIVE To present the UK experience to date with laparoendoscopic single‐site surgery (LESS) simple nephrectomy. PATIENTS AND METHODS Five female patients underwent LESS nephrectomy; three procedures were carried out with the umbilicus as the port of entry (U‐LESS). RESULTS All cases were completed uneventfully. The operative duration was 45–150 min and blood loss was negligible. There were no conversions to conventional multi‐port laparoscopy or open surgery. Recovery was uneventful with only minor complications in two patients; convalescence was rapid. CONCLUSION LESS nephrectomy offers a safe, cosmetic alternative to conventional multi‐port laparoscopy, with younger female patients being especially happier with the ‘scarless’ outcome of U‐LESS. LESS certainly appears to be more in these situations.

OBJECTIVE To evaluate medium‐term outcome data from patients with distal urethral cancers treated with penile‐preserving surgery. PATIENTS AND METHODS We analysed prospectively 18 consecutive men referred for the management of urethral carcinoma. All had a specialist review in a supra‐regional multidisciplinary team meeting, where the histology findings were reviewed by one pathology consultant. Tumours were staged according to the Tumour‐Node‐Metastasis classification and the patients offered penile‐preserving surgery when tumours were limited to the glanular or penile urethra. RESULTS All 18 patients were suitable for penile‐preserving surgery; the procedures were: three hypospadias formation with or without topical chemotherapy; four buccal mucosa urethroplasty; three glansectomy and reconstruction; six glansectomy, distal corporectomy, reconstruction and hypospadias formation; two urethrectomy with or with no excision of adjacent tunica albuginea. The mean (median, range) follow‐up was 26 (20.5, 9–58) months. There were no local recurrences; four patients with regional nodal disease progressed and of these, two died from metastatic disease, and one died from an unrelated condition. CONCLUSION Medium‐term data show that penile‐preserving surgery is a feasible treatment for men with distal urethral carcinoma, providing excellent local control without prejudicing survival; a longer follow‐up is needed.

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Background: Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion.