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Adrenal incidentalomas: what next?

An incidentaloma refers to an adrenal lesion >1cm discovered incidentally during radiologic examination. Identifying a malignant and / or functioning lesion is critical for management. However, as the majority of lesions are benign, the challenge is the identification of malignant...

Urinary biomarkers for surveillance of non-muscle invasive bladder cancer

Bladder cancer (BC) is the ninth most common cancer worldwide with a yearly incidence of approximately 430,000 cases. There is a male predominance and it is the seventh most common cancer in men worldwide [1]. Non-muscle invasive bladder cancer (NMIBC)...

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...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

How can we reduce morbidity after RARC with intracorporeal neobladder?

Robot-assisted radical cystectomy (RARC) is a complex procedure with high postoperative morbidity, especially when combined with neobladder reconstruction, which has a higher complication rate compared to other urinary diversions. To minimise these complications, it is crucial to understand their nature...

Immunotherapy in renal cancer

Renal cell carcinoma (RCC) is the sixth most common solid organ cancer in the UK. In 2018, there were 403,262 people diagnosed worldwide with the disease (2.2% of all cancer cases), and it accounted for 175,098 deaths in total (1.8%...

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...

Long term outcomes of primary ureterovesicostomy for the primary obstructive megaureter

Primary obstructive megaureter is dilatation of the ureter secondary to narrowing at the vesicoureteric junction (VUJ). Many (80%) require no intervention, however, a select number do for worsening hydroureteronephrosis, decreasing renal function, prolonged drainage time, recurrent urinary tract infections or...

Neuroendocrine bladder tumour

A 75-year-old male with a history of prostate adenocarcinoma (T3b/T4 N1 M1b, Gleason 4+3) on Zoladex® and enzalutamide, presented with visible haematuria. His prostate specific antigen (PSA) had decreased from 43.6ug/L in December 2022 to 0.02ug/L. He also had a...

Modern management of small renal masses

With the advent of widespread cross-sectional imaging there has been a surge in incidental detection of small renal masses (SRMs) and renal cell carcinoma (RCC) is now the seventh most common cancer in the UK. Whilst surgical excision for larger...

PUJO: Hellstrom principle revisited

This paper describes the result of four out of twenty-three cases (two males, two females) of pelvi-ureteric junction obstruction - PUJO - (mean age 18.25 years, range 16-20), mean follow-up two years (range six months – three years) that were...

Prostate Cancer – Diagnosis and Clinical Management

This rather modest looking paperback actually punches well beyond its humble appearance. There are of course the predictable sub-sections appropriate to any prostate cancer text – but that said this relatively small-volume affair (compared to some of the Goliaths out...