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Multiparametric MRI with targeted-only biopsy – a new standard?
In this issue of European Urology, Kasivisvanathan et al. present a meta-analysis of two randomised trials comparing prebiopsy MRI with targeted biopsy (TBx) alone versus standard transrectal ultrasound-guided biopsy (TRUS-Bx) in biopsy-naïve men at risk of prostate cancer. Their findings...A review of the diagnosis and management of urethral caruncles
Introduction The innocuous urethral caruncle is the most common benign urethral lesion in females. It can pose a significant challenge to urologists due to the plethora of differentials and poor evidence surrounding management. In 1926, Ferrier eloquently described the macroscopic...Urologic complications of radiotherapy
Case 1 1. What machine is seen in the picture? 2. What is the standard dose schedule for radiotherapy for prostate cancer? 3. What are the complications of radiotherapy? Case 2 1. How does haemorrhagic cystitis develop? 2. What are...Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?
Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...Priapism
Priapism is defined as an abnormally persistent erection lasting greater than four hours, not associated with sexual desire [1]. Although relatively uncommon with an incidence of 1.5 per 100,000 [2], priapism has a risk of complications which can have a...Physiotherapy first for pelvic floor dysfunction
Physiotherapy should be included in first-line management options for pelvic organ prolapse and urinary incontinence in women [1,2]. Additionally, referral to physiotherapy is widely practised for the management of urinary incontinence in men, faecal incontinence, defecation disorders and various pelvic...
Outcomes of VUR in children with non-neurogenic dysfunction treated with Deflux
The 2010 American Urological Association (AUA) guidelines on primary vesicoureteral reflux (VUR) state that children with VUR and lower urinary tract dysfunction are less likely to have the VUR resolve spontaneously than those with primary VUR alone (31% vs. 61%)....
The GMS hypospadias score
Hypospadias surgery has been carried out for decades. Descriptive parameters for hypospadias severity are variable and difficult to reproduce. The severity of abnormalities lies along a continuous spectrum. The paediatric urological fraternity is attempting to develop more reliable comparators for...
COVID-19: cancer and corticosteroids
Under the prevailing COVID-19 crisis, this article is well worth reading. The current World Health Organization (WHO) guidance is not to start steroids in cancer cases, but there is no clear evidence of risks with steroids in cancer patients having...
Refining management of non-visible haematuria
The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....
