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An update on robotic surgery in urology

The early adoption of new technology has long been a trademark of urological surgeons. Like the introduction of the cystoscope, lasers and flexible endoscopy, the field of urology has witnessed a revolutionary transformation with the advent of robotic surgery. Robotic-assisted...

Can the latest patient decision aid help OAB patients?

OAB Answers is a patient decision aid co-authored by several European urologists and gynaecologists, and two patient advocates, to help patients understand and manage their overactive bladder (OAB). It is a 36-page document split into several clear sections, aiming to...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

Sarcomatoid renal cell carcinoma

Renal cell carcinoma (RCC) represents 2-3% of all cancers [1]. It is an adenocarcinoma making up 85% of all renal malignancies. Sarcomatoid transformation is a microscopically identified feature of RCC accounting for 5% of all RCCs [2]. Known as sarcomatoid...

Prostate cancer management 2 – metastatic disease

A 72-year-old gentleman is referred to you in the two-week wait clinic with a prostate specific antigen (PSA) of 22ug/L. He is otherwise fit and well and does not take any regular medication. His multi-parametric magnetic resonance imaging (mpMRI) shows...

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...

Renal masses

Case 1 A 70-year-old female presented under the medical team with malaise, weight loss, and deranged liver function tests (LFTs) and calcium (ALP 350, GGT 650, Serum bilirubin 29, normal aminotransferases, Ca 3.3). An abdominal ultrasound scan (USS) was performed...

Peno-scrotal extramammary Paget’s disease

Epidemiology Extramammary Paget’s disease (EMP) is a rare intraepithelial neoplasm, which is rarely invasive and has an incidence of six per million person-years as calculated by a European SEER analysis [1]. It usually affects apocrine gland-bearing areas, especially the vulvar,...

Prostate cancer

Case 1 A 65-year-old man is referred to your two-week wait (2WW) clinic with a PSA of 7.0ng/mL. He has no lower urinary tract symptoms (LUTS), no past medical history, no family history of prostate cancer (PCa) and his performance...

Is AS in SRM more convincing than in prostate cancer?

This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...

Surgical and pathological outcome of partial nephrectomy: robotic versus laparoscopic approach

Nephron sparing surgery has become the standard surgical treatment for small renal masses (<4cm). Laparoscopic partial nephrectomy (LPN) is shown to be superior to the open approach (OPN) in peri and postoperative morbidity; however, it requires advanced skills and has...

Cryotherapy for small renal masses: better than surveillance?

With the rapid rise in incidental small renal mass detection, some of which have malignant potential, comes the need to either survey or treat these masses safely and with minimal morbidity. This large series of 147 patients with 171 masses,...