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The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...

Demanding cases or nightmares in endourology? Sep/Oct 2015

One of the most interesting aspects of attending international meetings is the rare but invaluable, honest presentation of complex cases. We aim to present the readers with some complex and challenging ongoing cases in endourology. Case 1 A general practitioner...

New study shows UK may finally be ready for prostate cancer screening

Prostate Cancer UK study shows tens of thousands fewer men each year face unnecessary harm thanks to new screening techniques. New research by Prostate Cancer UK shows that the UK may finally be in a position to roll out a...

Recent advances in the management of castration resistant prostate cancer

Castrate resistant prostate cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy lowering testosterone to castrate levels. It may present as a rise in serum levels of prostate specific antigen (PSA), progression of pre-existing disease, or the appearance of...

Tissue-based biomarkers steering clinical decisions in patients with urothelial cancer

Biomarkers play an essential role in the diagnosis and treatment of urothelial cancer (UC), with PD-L1, FGFR, and MMR proteins being the most clinically established. These biomarkers, derived from histological specimens, guide therapeutic decisions for bladder cancer (BCa) and upper...

A greener urology

Healthcare in England is responsible for 4-5% of the country’s carbon footprint which is defined as the amount of greenhouse gasses, primarily carbon dioxide, released into the atmosphere by a particular activity. The six greenhouse gasses which vary in their...

Wax candles, horsewhips and sounding a note

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). There are certain instruments we use in urology which carry unusual names; you...

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...

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...

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...

Sacral agenesis and neurogenic bladder: long-term outcomes of bladder and kidney function

These authors looked at single institution outcomes for sacral agenesis (without spina bifida) with reference to renal function and bladder function. All had urodynamics either at diagnosis (56%) or soon after. Of 43 patients (23 female, 20 male), 37 had...

Urology patient assessment – importance of holistic approach – new paradigm

Mild cognitive impairment (MCI) seems to affect 30% of the general population above 65 and its presence has a wide range of significance. This is a prospective single centre study to look at MCI in adult urological patients above 18...