Journal Reviews
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...
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...
Accuracy of cognitive vs software-guided MRI-targeted biopsy
The FUTURE randomised trial showed no difference in prostate cancer (PCa) detection between cognitive, in-bore and software guided MRI-targeted biopsy (TBx) techniques, a finding supported by meta-analyses and reflected in European Association of Urology (EAU) guidelines. However, whether any TBx...
Should expert genitourinary pathology review of orchiectomy specimens be mandatory?
This article contains recommendations from the European Association of Urology Guidelines Panel on Testicular Cancer and argues that centralised review of orchiectomy specimens by expert genitourinary pathologists would contribute to better patient management. Accurate pathological assessment is fundamental to the...
The future of bladder preservation for muscle-invasive bladder cancer
Localised muscle-invasive bladder cancer (MIBC) has historically been treated with radical cystectomy (RC), but bladder preservation therapy (BPT) has emerged as a credible and increasingly refined alternative. Early work by Herr in the 1980s demonstrated that radical transurethral resection of...
Is transperineal prostate biopsy without antibiotic prophylaxis the new gold standard?
Prostate cancer is the second most diagnosed malignancy among men worldwide. Despite substantial advances in MRI–guided diagnostic pathways, prostate biopsy with histopathological evaluation remains indispensable for definitive diagnosis. Historically, transrectal biopsy (TRBx) has been the standard approach; however, concerns regarding...
Boosting the immune response to Bacillus Calmette-Guérin
In this issue of European Urology, Buisan et al. report early clinical and immunological outcomes of subcutaneous priming with the non-live mycobacterium tuberculosis RUTI vaccine prior to intravesical Bacillus Calmette-Guérin (BCG) in patients with non-muscle-invasive bladder cancer (NMIBC). The phase...
Prostate cancer detection in younger men
Prostate cancer (PC) screening using prostate-specific antigen (PSA) testing with systematic biopsy (SBx) reduces mortality but risks overdiagnosis and unnecessary biopsies. Multiparametric MRI (mpMRI) enables MRI-targeted biopsy (TBx) of suspicious lesions and is now recommended before biopsy, although its role...
The case against omitting systematic biopsy in younger men
In this issue of European Urology, Al-Monajjed et al. report findings from the PROBASE trial, which evaluated prostate cancer (PC) detection in men aged 45–50 years with PSA ≥3ng/ml using both MRI-targeted biopsy (TBx) and systematic biopsy (SBx). Among 525...
Multiparametric MRI with targeted-only biopsy – a new standard?
In this issue of European Urology, Kasivisvanathan et al. present a meta-analysis of two randomised trials comparing prebiopsy MRI with targeted biopsy (TBx) alone versus standard transrectal ultrasound-guided biopsy (TRUS-Bx) in biopsy-naïve men at risk of prostate cancer. Their findings...
