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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...

Is AS in SRM more convincing than in prostate cancer?

This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...

PFMT in males

Pelvic floor muscle training (PFMT) has been described since ancient times in Rome but Kegel popularised it to improve sexual and urinary health after childbirth. In the paediatric population, there is a paradigm shift towards biofeedback-based PFMT for lower urinary...

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...

Prostatic artery embolisation – an option for select BPO patients

Few proponents of prostatic artery embolisation (PAE) regard it as a potential standard in future for benign prostatic obstruction (BPO) / benign prostatic hyperplasia (BPH) treatment. Present guidelines from the National Institute for Health & Care Excellence (NICE) and the...

Keep it simple: a proposal for a new definition of uncomplicated and complicated UTIs

Urinary tract infections (UTIs) are one of the most common bacterial infections in both community and healthcare settings, leading to frequent antibiotic use. They range widely in severity, from mild cases like cystitis to severe, potentially life-threatening conditions such as...

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...

Textbook of the Neurogenic Bladder (Third Edition)

The third incarnation of this popular tome remains as imposing as ever. However, it has less the feel of an encyclopaedia about it than one might initially have feared. Whilst there is clearly some very great detail here – with...

Long-term bladder drainage: blessing or disaster in disguise

Chronic bladder dysfunction occurs in many neurologic disorders e.g. multiple sclerosis, Parkinson’s disease, stroke, etc. Suprapubic catheters (SPC) are inserted every day and every urology department has a pool of ‘difficult’ patients who keep coming back. This paper compares SPCs...

Who was Zoon?

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). Eponyms are frowned upon in modern medical teaching but, as a medical historian,...

An update on erectile dysfunction guidelines and treatment options

Erectile dysfunction is defined as the persistent inability to attain and / or maintain an erection sufficient for sexual performance. Not only does this have a psychosocial impact, it also affects the quality of life of both the patients and...

MRI screening for prostate cancer: a step towards a ‘prostagram’

The UK National Screening Committee has been calling for further research into alternative screening tests for prostate cancer. The committee decided against prostate cancer screening using prostate specific antigen (PSA) testing on the basis that “PSA is still a poor...