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...
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...
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...
FANS f-URS with mPCNL for 2–3cm renal stones
Flexible ureteroscopy (f-URS) has undergone substantial evolution with the introduction of flexible and navigable suction ureteral access sheaths (FANS), expanding its applicability to larger renal calculi. Although mini-percutaneous nephrolithotomy (mPCNL) remains a standard treatment for 2–3 cm renal stones, uncertainty...
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...
