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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...

Psychosocial distress in parents of children with DSD

Disorders of sex development (DSD) are a rare set of medical conditions with prevalence rates ranging between 1:00 to 1:5000 births. Secondary atypical genitalia is seen in a subset. Psychosocial aspects have until recently been understudied. We know that some...

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...

Emergency department revisits for patients with ureteral stones

The authors aimed to identify clinical predictors for emergency department (ED) revisits in patients diagnosed with ureteral stones. Patients presenting between 2010 and 2013 were included. Those who were admitted at the initial presentation were excluded. CT scans were reviewed...

Kidney stones in pregnancy

Case 1 A 28-year-old female, 19 weeks pregnant, presents with severe left loin pain. There is no past medical history of note. Blood tests show a white cell count of 14.1x109/L and creatinine of 56umol/L. An ultrasound scan (USS) reports...

PSA screening in limbo: how low should we go?

One may wonder how the management of prostate cancer could have evolved differently if it had followed a path similar to breast cancer. In breast cancer, early detection in the 1970s relied heavily on imaging because no reliable circulating biomarker...

Clinical Trials 2 – key papers

Clinical Trials 1 is available here. Case 1 This British study on haematuria clinic diagnostic yield was published in the British Journal of Urology International in 2006. The results are often asked in examinations! Edwards TJ, et al. A prospective...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Bedside teaching

All of us are involved in the teaching and training of under or postgraduate medical students and nurses. This article gives a patient’s perspective and thoughts on being an ‘interesting’ patient within a ward or clinic setting. Important points to...

The importance of assessing frailty in patients prior to radical prostatectomy

This large-scale retrospective study evaluated the short-term postoperative outcomes in patients with localised prostate cancer treated with radical prostatectomy (RP). Both body mass index (BMI) and Charlson comorbidity Index (CCI) are well established indicators of adverse outcomes post major surgery,...

Lichen sclerosus and isolated bulbar urethral stricture disease

The incidence of urethral stricture in men with lichen sclerosus (LS) has been reported to be between 4.8% and 14%. LS limited to the glans and urethral meatus can be treated with acceptable outcomes; however, more extensive urethral disease requires...