Hydration with intravenous normal saline is the mainstay of treatment together with frusemide (not thiazides). Intravenous bisphosphonates (pamidronate) is indicated if there is lack of response to hydration, very high calcium levels, obtundation or severe symptoms. Patients with renal failure may need dialysis.

Calcitonin is a very expensive option; it works very quickly but exhibits tachyphylaxis.

Treatment of underlying disease would depend on stage of tumour, patient co-morbidities and prognosis (e.g. localised renal carcinoma vs. end stage metastatic bladder TCC). Ongoing control may involve oral bisphosphonates or periodic IV treatments [15, 16].

Treatment of urogenital malignancy often involves major surgical procedures (e.g. radical prostatectomy, cystoprostatectomy and nephrectomy). As the incidence of many urological cancers increase with advancing age, surgery is being considered for a growing number of older patients often with multiple co-morbidities and less able to cope with post-operative complications. Some of these patients may well be nursed in high dependency units as indicated. An understanding of the common post-operative emergencies related to the surgical procedure is essential for satisfactory perioperative management and achieving good outcomes.