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Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?

Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...

Developing a risk calculator to predict cancer in patients with haematuria: The IDENTIFY Study

Patients with haematuria require investigations to rule out urinary tract cancer. We know that the most common cancer found during these investigations is bladder cancer, whereas upper tract cancers such as renal cell carcinoma and upper urinary tract urothelial cancer...

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...

The microbial syndicate: dysbiosis and origins of recurrent UTIs

Traditional dogma held that urine was sterile. However, recent molecular studies have revealed an underground microbial community, known as the urinary microbiome or ‘urobiome’ [1]. Far from being harmful, this community of microorganisms helps modulate immune responses, regulate inflammation, and...

Artificial penile pearls: what every Urologist should know!

Penile implants are inert objects placed beneath the skin of the penis through an incision. These are variously referred to as Yakuza beads, pearls, ball bearings, speed bumps, penile marbles, inserts, etc. The term ‘penile implant’ described here should not...

Enhancing performance and wellbeing for surgeons: the science of life coaching

Life coaching has emerged as a powerful personal and professional development tool, particularly for individuals navigating high-stakes environments. Life coaching emphasises self-awareness, self-management and self-efficacy, including establishing desired outcomes, goal setting and developing skills and action plans to achieve them....

Enhancing performance and wellbeing for surgeons: the science of life coaching

Life coaching has emerged as a powerful personal and professional development tool, particularly for individuals navigating high-stakes environments. Life coaching emphasises self-awareness, self-management and self-efficacy, including establishing desired outcomes, goal setting and developing skills and action plans to achieve them....

Prostate cancer series: diagnostics 1

- Click here for Part 2 - A 58-year-old male is referred to your rapid access prostate clinic with a prostate specific antigen (PSA) of 6.0ng/ml. He has no lower urinary tract symptoms (LUTS), past medical history (PMH), or family...

Challenges of catheter associated urinary tract infection: is prevention better than cure?

Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...

Digital Twins: From NASA to the clinic

Clinical practice generates an enormous amount of patient data – histories, observations, blood results, imaging and molecular biomarkers. The problem is that these data streams rarely talk to each other. Instead, we use them in isolation, when what we actually...

How to handle the opening market in robotic surgery

In the latest edition of European Urology, Thillou et al. present a groundbreaking case series comprising 10 instances of robotassisted radical prostatectomy (RARP) procedures conducted using the innovative Dexter robotic system by Distalmotion SA, Épalinges, Switzerland. This marks the maiden...