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Hypospadias – can urologists achieve the unachievable?

US News & World Report (USNWR) provide rankings on a wide range of topics (education, health, money, travel, cars and law firms). In terms of healthcare, they suggest that their rankings (based on metrics) are a tool that can help...

Preoperative testosterone for hypospadias

Hypospadias affects around 1 in 400 boys. Glans width (GW) of <14mm has been shown to be an independent risk factor for urethroplasty complications following hypospadias repair. Testosterone (T) administration in prepubertal males increases both penile length and circumference. Its...

Phase two trial of SAbR for primary RCC

A study focused on stereotactic ablative radiotherapy (SAbR) as a treatment for primary renal cell carcinoma (RCC) has yielded significant findings. The primary objective of the study was successfully met, demonstrating a 94% local control rate at one year among...

Patients’ preferences for additional (cytoreductive) treatments to the prostate and metastasis in metastatic prostate cancer

Patients diagnosed with metastatic prostate cancer at first diagnosis or de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) have had reported increases in overall survival due to rapid advances and intensification of systemic therapy regimes beyond traditional androgen deprivation therapy...

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...

Supporting chronic cystitis patients through the winter

The current pandemic is causing severe disruption to the care of patients with non-life-threatening conditions.

Malignant upper urinary tract obstruction: emergency presentations and long-term outcomes

Malignant upper urinary tract obstruction (MUUTO) is a frequent emergency urological referral, often necessitating kidney drainage to preserve renal function. However, many patients have advanced cancer with limited life expectancy, raising questions about intervention benefits. While percutaneous nephrostomy (PCN) or...

Management dilemma for very high-risk non–muscle-invasive bladder cancer

The European Association of Urology (EAU) guidelines recommend upfront radical cystectomy (RC) for very high-risk (VHR) non-muscle-invasive bladder cancer (NMIBC). However, real-world adoption is limited, as most patients are reluctant to undergo immediate bladder removal. The EAU 2021 risk model...

Are urodynamics still useful?

Two major UK randomised controlled trials, UPSTREAM and FUTURE, compared comprehensive clinical assessment (CCA) alone with CCA plus urodynamics (UDS), incorporating filling cystometry and pressure–flow studies. Both trials involved patients in whom diagnostic uncertainty suggested a potential role for UDS...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

Challenges of upper tract urothelial carcinoma

Upper tract uroepithelial carcinoma (UTUC) is a fairly common disease which traditionally had poorer outcomes compared to bladder cancer. This is due to various factors leading to delayed diagnosis and problems in risk stratification. Continuing efforts have focused on early...

NICE has recently moved the IRE guidelines from ‘Research Only’ to ‘Special Arrangements’

This recent update provides increased access to the AngioDynamics NanoKnife IRE ablation...