Journal Reviews
Prostate size in transwomen on gender-affirming hormone therapy
This study examined prostate size and characteristics in transgender females (TF) receiving hormone therapy (HT) and androgen deprivation (AD). Although gender-affirming surgery may include orchiectomy and vaginoplasty, most TF and gender-nonconforming individuals who were assigned male at birth retain their...
Prevalence of germline pathogenic variants in patients with metastatic prostate cancer
In this study, 5.9% of Dutch patients with metastatic prostate cancer (mPCa) carried a germline pathogenic variant (gPV) in a DNA damage-repair (DDR) gene. Consistent with international data, gPVs in CHEK2, ATM and BRCA2 were significantly more common in mPCa...
Practice makes perfect – but does the HoLEP learning curve affect sexual function?
This article poses an interesting question: whilst we know there is an association with HoLEP and ejaculatory dysfunction (BAUS quotes a 90% risk for retrograde ejaculation), is this risk dependent on surgeon experience and their learning curve with HoLEP? This...
Comparing retroperitoneoscopic and endourological approaches for upper ureteric and renal pelvic calculi
Urinary tract stones affect approximately 5–10% of people in developed countries. Advances in urological treatment have provided several surgical options, including ureteroscopic lithotripsy (URSL), retrograde intrarenal surgery (RIRS), percutaneous nephrolithotomy (PCNL), extracorporeal shock wave lithotripsy (ESWL), and minimally invasive laparoscopic...
Refining the role of androgen deprivation therapy after radical prostatectomy
A rising prostate specific antigen (PSA) after radical prostatectomy represents a pivotal moment in prostate cancer management, with salvage radiation therapy (RT) the standard intervention. However, the optimal role and duration of androgen deprivation therapy (ADT) alongside RT remain debated....
Why perform PLND?
Pelvic lymph node dissection (PLND) during radical prostatectomy has historically been recommended for staging purposes and a potential oncological benefit. Extended PLND (ePLND) provides more accurate staging, detecting more lymph node (LN) metastases than limited PLND (lPLND). This information helps...
Haematuria after transurethral resection of bladder tumour
Transurethral resection of bladder tumour (TURBT) is a common urological procedure, primarily for urothelial carcinoma, with smoking being the leading risk factor. Many patients are on antithrombotic agents (ATAs – antiplatelets or anticoagulants), which increase bleeding risks. Despite guidelines on...
Five-year outcomes following negative MRI or biopsy in the RAPID diagnostic pathway
The Rapid Assessment for Prostate Imaging and Diagnosis (RAPID) pathway was introduced in UK urology centres to streamline prostate cancer diagnosis using an MRI-directed approach. Men with elevated PSA undergo upfront multiparametric MRI (mpMRI), and biopsy is reserved for those...
Robotic vs. open ureteral reimplantation
Ureteral stricture disease is a frequent and complex problem in urological practice, most commonly arising from iatrogenic injury. Although its exact incidence is difficult to determine, reported rates range from 0.3–2.5% following gynaecological surgery, approximately 3% after ureteroscopy, and up...
Evaluating the ‘two-week wait pathway’ for testicular cancer
The ‘Two-Week Wait’ (2WW) pathway is central to the NHS cancer strategy, ensuring rapid review of suspected malignancies. For testicular cancer, NICE NG12 advises urgent referral based solely on clinical suspicion (typically a solid, non-transilluminable scrotal mass) without requiring prior...
PARP inhibitors and prostate cancer
The discovery that BRCA1/2-deficient tumour cells are highly sensitive to poly-ADP ribose polymerase (PARP) inhibitors (PARPi) established the foundation of synthetic lethality in metastatic castration-resistant prostate cancer (mCRPC). The TOPARP-A trial confirmed clinical benefit, with PARPi activity largely restricted to...
Comparison of CHOKAI, STONE and STONE PLUS scores
The prevalence of urinary stones is steadily increasing due to changing dietary habits and living conditions, leading to a significant number of emergency department (ED) visits, primarily for severe pain. While managing pain is crucial, accurate diagnosis remains essential. Non-enhanced...
