Where possible PH should be drained in an operating theatre. Multicentre randomized controlled trials are required to further investigate the impact of drainage technique and post-drainage management on outcome.

Only four early years postgraduate surgical training posts in the UK meet nationally approved minimum quality standards. Specific recommendations are made to improve training in this cohort and to bolster recruitment and retention into Higher Surgical Training.

No abstract

Background: Penile fracture is a urological emergency that occurs following a traumatic rupture of the tunica albuginea. Patients experience an audible ‘pop’ and immediate detumescence during sexual activity, followed by pain, swelling and ecchymosis. It is uncommon for patients to present without these typical clinical findings. Case Presentation: This case report describes a 33-year-old male with an atypical penile fracture and associated urethral injury. He reported mild pain as his penis buckled against his partner’s thigh during sexual intercourse and a sudden detumescence. Examination was unremarkable other than gross blood at the external urethral meatus. MRI identified a 4 mm focal capsular defect at the ventral aspect of the left corpora cav-ernosum. Flexible cystoscopy identified a 2cm longitudinal tear in the distal urethra. The patient underwentsuccessful surgical repair with no long term sequalae.Conclusions: The authors of this report wish to highlight the importance of keeping a high index of suspi-cion for penile fractures in light of a typical history.

Over the last decade, there have been vast advancements in endourology, with innovation lead-ing to large renal stones being successfully treated with minimal to no incisions.As the elderly population is growing, we are seeing a trend of more complicated stone patients who are not suitable candidates for percutaneous nephrolithotomy (PCNL) and would require several attempts with conventional flexible ureteroscopy.We aim to share our experience using the ClearPetra Suction Access Sheath and UROFINO Disposable Ureteroscope to completely fragment a large renal stone in a frail elderly patient in a single sitting.