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Introduction:Priapism is one of the few critical male urological emergencies. There are two main types of priapism, low flow/venous and high flow/arterial priapism. Malignant priapism is a rare subtype of low flow priapism usually secondary to pelvic malignancy, but other extra-pelvic primary cancers cannot be completely excluded.Aim:To assess and highlight the poor prognosis of malignant priapism, with a view to directing management towards both symptomatic relief and improving patients’ quality of life.Method:All reports of malignant priapism between 1998 and 2018 were searched and assessed focusing on the primary cancer, duration of complaint, associated symptoms, method of management and prognosis.Conclusion:Malignant priapism is a rare form of ischaemic priapism, resistant to successful therapies utilized in the management of other forms of ischaemic priapism. Urological cancers are the most common primaries implicated with the most commonly associated symptoms being pain and urinary symptoms. In the absence of any evidence based guidelines and reliably successful treatment options, clinicians should aim to employ supportive treatment strategies including adequate analgesia.Level of evidence:level4

Transurethral resection of bladder tumour (TURBT) is the first step in management of bladder cancers. A urology trainee in the UK must do at least 120 procedures during their training years before being a consultant. In our article, we are reporting a retrospective audit of the quality of TURBT across 2 major cancer centres in Lancashire. We assessed the adherence of surgical procedure to the national and international guidelines among different grades of urological surgeons who work in the 2 trusts.

The ‘Portsmouth Tonsillitis Protocol’ by Bird et al. (October 2013 issue)[1] provides the first published treatment algorithm for use in patients with acute tonsillitis presenting to secondary care. Following introduction of the protocol at their centre the authors demonstrate an improved delivery of tonsillitis treatment as well as a reduction in hospital admission rates and inpatient services leading to significant cost savings. The financial implications are particularly relevant to health services facing economic pressures. This article is protected by copyright. All rights reserved.