Features
The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy
Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...
Consent: your obligations in the modern, post-Montgomery era
There has been so much recent discussion and so much emphasis placed on the fundamental right that we all have to determine what is or is not done to us, the right to self-determination, that it would be either a...
Small renal masses – diagnosis and management
Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...
An introduction to research governance
Research is the process of acquiring new generalisable knowledge and should be fully integrated into healthcare work. There is a growing drive to encourage and further develop evidence-based practice in medicine so that staff and patients benefit from improved healthcare...
Focal therapy for prostate cancer – ready for prime time?
The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...
An update on antibiotic prophylaxis in TRUS-guided prostate biopsy
Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...
The surgical trainer – are we still evolving?
“We need a system and we will surely have it – which will produce not only surgeons, but surgeons of the highest type” William Halsted MD William Halsted, a famous American surgeon, is widely credited with developing the first formal...
Bladder cancer: where are we with intravesical therapies?
In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...
A time management guide for urologists
Good time management is thought to not only reduce stress, but to improve personal efficiency, service delivery, clinical effectiveness and patient care. It was Benjamin Franklin in the 18th Century who originally made the link between success and the proper...
Use of Clavien-Dindo classification in urology part 2 – upper tract
A classification system of surgical complications was proposed by Clavien in 1992 [1] and further modified by Dindo in 2004 [2]. Clavien-Dindo classification has since then been validated through many retrospective case series as well as in comparative studies to...
Consensus statements on PSA testing in asymptomatic men in the UK
In January 2016, the UK National Screening Committee once again recommended against a systematic population screening programme for prostate cancer due to the, as yet, insufficient evidence that the benefits of screening would outweigh the harm to the population as...
The scent of Ethiopia: a personal story – part 1
Background The year was 2004; I had just moved to the UK as a young house officer and finished my observership programme at Great Ormond Street Hospital in London. I was inspired by greats like Patrick Duffy and Phillip Ransley,...
