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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...
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...
When can antibiotic prophylaxis be stopped for VUR in children?
Continuous antibiotic prophylaxis (CAP) is the mainstay of treatment and reduces the risk of febrile urinary tract infections (fUTI) in children with VUR. Thus far, there are no clear management guidelines as to whether and when CAP may be safely...
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...Supporting Patients Receiving Hormone Therapy: Introducing LiveWell
Androgen deprivation therapy (ADT) is a cornerstone of prostate cancer treatment, yet up to 30% of men experience significant long-term side effects affecting physical, metabolic, and psychological wellbeing. While there is strong evidence supporting exercise, lifestyle, and psychosocial interventions, access...
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...
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...
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...
Patients’ preferences for additional (cytoreductive) treatments to the prostate and metastasis in metastatic prostate cancer
Patients diagnosed with metastatic prostate cancer at first diagnosis or de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) have had reported increases in overall survival due to rapid advances and intensification of systemic therapy regimes beyond traditional androgen deprivation therapy...
Treatment options for renal cell carcinoma
In this issue of European Urology, experts review advancements and challenges in treating renal cell carcinoma (RCC), emphasising the complexity of managing a disease with an expanding array of therapeutic options. Despite significant progress, critical questions remain about treatment sequencing,...
First and second-line treatments in metastatic renal cell carcinoma
Over the past two decades, the treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly, leading to a quadrupling of patient survival rates. Modern systemic treatments include combinations of anti-PD-1 antibodies with either anti-CTLA-4 antibodies or antiangiogenic tyrosine...
