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Advanced prostate cancer and chemotherapy

The treatment pathway for advanced prostate cancer is both puzzling and complex and varies from centre to centre in the UK. The National Prostate Cancer Audit Report 2019 for England and Wales shows that only a quarter of men with...

Increased use of active surveillance for men with intermediate risk prostate cancer

The optimal management of men with intermediate risk prostate cancer remains unclear and continues to be debated. The authors interrogate the US National Cancer Database for 176,122 men diagnosed with intermediate risk prostate cancer between 2010 and 2016. Of these...

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 risk of tumour recurrence in patients undergoing renal transplantation for end-stage renal disease

End stage renal disease (ESRD) patients in need of a kidney transplant who have a previous history of urological cancer should undergo a cancer-free waiting period before receiving a kidney transplant. Currently the recommended waiting time is based on the...

Paediatric urology – peno-scrotal

Case 1 A four-year-old boy presents to clinic following GP referral unable to retract the foreskin (Figure 1). Figure 1. What is the diagnosis? The above condition may be pathological or physiological; clinically how can you differentiate this? Explain the...

MAPLe – the pelvic floor in high definition. One probe, all dysfunctions

The MAPLe high-definition technology enables you to diagnose and view a patient’s individual pelvic floor muscle EMG activity at a glance, making it possible for you to provide a more...

Recent developments in bladder cancer – NMIBC

Every year, roughly 10,300 individuals are diagnosed with bladder cancer in the UK, making it the 11th most common cancer in the UK, and the eighth most common cancer in men [1]. Of those diagnosed with the disease, 75-85% will...

PREDICT Prostate – individualised, evidence-based estimates of survival and treatment benefit

Earlier this year ‘PREDICT Prostate’ was launched online alongside a high-profile publication in PLOS Medicine. The prognostic model and decision-aid has been designed to inform treatment decision-making among men newly diagnosed with non-metastatic prostate cancer. David Thurtle and Vincent Gnanapragasam...

Keeping your eye on the ball: atypical presentations of testicular malignancy

Most testicular cancers present with a painless lump on the testes, and most are confidently diagnosed on examination and ultrasound. They have an excellent prognosis, with 90% patients alive at 10 years [1]. However, advanced testicular cancer, or those with...

ASAP: is a repeat biopsy necessary?

This study examined the validity of current US and European guidelines on the management of patients diagnosed with atypical small acinar proliferation (ASAP). Current guidance states that these patients should undergo repeat biopsy within three to six months due to...

Interpretation of Urodynamic Studies

It does not matter if you are the kind of person who gets excited by books on urodynamics or someone who just wants to learn a new skill, you need to get your hands on this book as it blows...

MRI targeted transperineal prostate biopsy: a local anaesthetic approach

Transperineal template biopsy remains the gold standard investigation in diagnosis of prostate cancer. Data from the PROMIS study demonstrated the low sensitivity of transrectal ultrasound (TRUS) biopsy as a diagnostic tool, and highlighted the need for a better diagnostic pathway....