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Prilocaine irrigation for pain relief after TURP

Transurethral resection of the prostate (TURP) is one of the commonest procedures undertaken by urologists. There are well known complications following the procedure which commonly include haematuria but also TUR syndrome, failure to pass urine and infections, amongst others. The...

Trade-offs between risks and benefits of localised prostate cancer treatments – the COMPARE study

We know little about the trade-offs men make when considering the oncological and functional outcomes of individual treatment options for localised prostate cancer, and decisions are often influenced by physician opinion. The likely compromised functional results are viewed as a...

PIRADS-3 lesions and clinically significant prostate cancer – what are we missing?

The use of pre-biopsy MRI has definitely enhanced our decision making in managing patients with suspected prostate cancer (PCa). There is still uncertainty around the outcomes for patients with PIRADS-3 lesions, with a small but definite risk of missing clinically...

Has laparoscopic radical prostatectomy had its day?

Over recent years there has been a massive uptake in robotic surgery particularly for robot-assisted prostatectomy. The drive for this has been patient and physician led with little in the way of prospective randomised trials showing benefits over established operative...

Cord compression in cancer

This article will be of great interest to uro-oncologists. Vertebral metastasis occurs in 3-5% of all cancers (most commonly in prostate, breast and lung cancer). It can cause pain, vertebral collapse and cord compression. Data from the National Institute for...

Early British pioneers of urological imaging

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). In this article I am joined by Gavin Gordon of Newcastle University whose...

Cryotherapy in prostate cancer

This review of the literature aims to summarise what is known in regards to outcomes in patients undergoing cryotherapy in a number of settings: whole gland, salvage and targeted focal therapy. It highlights that more prostate cancers are being diagnosed...

Prostate cancer mortality among elderly men after discontinuing organised screening

This study presents ground-breaking insights into discontinuing prostate cancer (PCa) screening in previously screened elderly men, aiming to mitigate the risk of overdiagnosis and overtreatment in the face of other-cause mortality. Examining men aged 70–74 who had undergone prostate specific...

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...

Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

Prostate cancer detection in younger men

Prostate cancer (PC) screening using prostate-specific antigen (PSA) testing with systematic biopsy (SBx) reduces mortality but risks overdiagnosis and unnecessary biopsies. Multiparametric MRI (mpMRI) enables MRI-targeted biopsy (TBx) of suspicious lesions and is now recommended before biopsy, although its role...

Is transperineal prostate biopsy without antibiotic prophylaxis the new gold standard?

Prostate cancer is the second most diagnosed malignancy among men worldwide. Despite substantial advances in MRI–guided diagnostic pathways, prostate biopsy with histopathological evaluation remains indispensable for definitive diagnosis. Historically, transrectal biopsy (TRBx) has been the standard approach; however, concerns regarding...