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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...

Urinary incontinence in women – part 2: management

In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...

Post CCT fellowship in genitourethral reconstruction at St George’s Hospital: an experience unique to the UK

I first developed an interest in genitourethral reconstruction, particularly urethroplasty, at the beginning of my urology training. Working in Bristol and Weston Super Mare for David Dickerson inspired me to develop this further. Mr Dickerson performs one of the largest...

Burnout – a personal story

My name is Michael, and I am a urology ST5 registrar based in the West Midlands. Growing up in a Far East Asian household, I watched my father, a gynaecologist, and my mother, a parasitologist, devote countless hours to their...

Delivering a trainee-led Urolink educational programme – my experience in Tanzania

In May 2023, I travelled to Moshi, Tanzania, where I visited Kilimanjaro Christian Medical Centre (KCMC) – a trip which was made possible through the collaborative efforts of the British Association of Urological Surgeons (BAUS) Urolink and with the support...

Upper tract abnormalities

Case 1 Figure 1. A 26-year-old female presents to A&E with loin pain. What do the CT images in Figures 1 (left, centre and right) show? What is the prevalence of the congenital anomaly in the general population, and is...

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...

Artificial intelligence

Artificial intelligence concerns me. Generally, people still tend to be concerned that their livelihoods will be replaced by an all powerful, all knowing artificial intelligence (AI) system. This at a time when the world’s largest technology companies (Amazon, Google, Apple),...

Scalpels and stunts: reflections from an academic trainee and international-level athlete

When people find out I’m a urology registrar, they usually nod politely or giggle for obvious reasons. When they find out I’m also a competitive cheerleader, they tend to blink, pause, and then ask: “Wait, like pom-poms and high kicks?”...

Long-term oncologic outcomes of salvage cryoablation for rrPC

Of patients undergoing radiotherapy (RT) for prostate cancer (PC), at least 15-20% will experience recurrence. Although salvage prostatectomy achieves durable oncological outcomes at 10 years, it is associated with significantly high morbidity. Thus, the majority of men with radio-recurrent prostate...

All biochemical recurrences are equal, but some are more equal than others

Despite significant technological advancements, radical prostatectomy (RP) and radiotherapy (RT) are not always effective in curing localised prostate cancer (PCa). Many patients experience a rise in prostate-specific antigen (PSA), known as biochemical recurrence (BCR), leading to considerable anxiety and a...

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...