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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...

Urolithiasis 4 - Staghorn calculus

Case scenario A 64-year-old woman with recurrent urinary tract infections and left flank pain undergoes investigations as an outpatient. Figure 1a. Figure 1b. 1. Describe Figures 1a and 1b. 2. Her co-morbidities are type 2 diabetes (which is well controlled)...

An amateur’s trek into the Urology Boot Camp

Driven by a strong desire to pursue a career in medicine, I was lucky to get an opportunity to attend the Urology Boot Camp at Leeds while still in sixth form. Although urology is a postgraduate specialty, I wanted to...

Comparison of pathological stage in patients treated with and without neoadjuvant chemotherapy for high-risk UTUC

High-risk upper tract urothelial carcinoma (UTUC) has been associated with poor survival outcomes. The authors evaluated the role of neoadjuvant chemotherapy in high-risk cases prior to radical nephroureterectomy (RNU) in terms of pathological stage of the final surgical specimen. A...

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...

History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

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...

Prostate cancer nurse specialist shortage: a view from the coal face

Prostate Cancer UK recently reported that there is an impending crisis for men with prostate cancer, simply because the number of nurse specialists available is insufficient for their needs [1]. Background As has been widely reported, the incidence of prostate...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

Obesity and Urologic cancers: A student’s perspective on risk, systems and surgical implications

During my clinical placements, I began to notice that some patients did not fit neatly into the scenarios we learned about in lectures. One patient in particular had a raised PSA and several comorbidities, including obesity. What stood out was...

Are standard repeat biopsies during active surveillance for prostate cancer still necessary?

Active surveillance (AS) has emerged as a key strategy for managing low-risk prostate cancer (PCa), offering an alternative to immediate treatment. Initially, AS relied on prostate specific antigen (PSA) testing, digital rectal examinations (DRE), and systematic biopsies. Early studies using...