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Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer
Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...
Increasing PSA after negative prostate biopsy - solving the clinical puzzle
There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...
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...
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)...SmashUrology: The Question Bank for FRCS (Urol) and FEBU Exam Preparation
SmashUrology is an online educational platform developed specifically to support urology trainees preparing for the FRCS (Urol) and FEBU examinations. Founded by Ibrahim Ibrahim, a senior urology registrar based in Glasgow, the platform was created in response to a lack...Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder
Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...Frailty in urology – part 2
The first article in this series defined frailty and introduced the concept and importance of identifying patients living with frailty who undergo surgery, including those undergoing urological procedures. In the second part of this series we outline how to identify...
Treatment of varicocele in children and adolescents
Varicocele occur in about 15% of all adolescents. These authors searched Medline, Embase and a number of platforms reporting on varicoses in children and adolescents, including only randomised controlled trials with patients under 21 years. After an initial 198 studies...Bladder cancer
Case 1 A 78-year-old female presents with a week history of painless haematuria. She’s a smoker and used to work in the textiles industry. She underwent a flexible cystoscopy. What does this image show? What are the two-week wait National...An update on mobile apps in urology
Amongst the plethora of mobile applications, there are some essential applications for practising urologists, urologists in training and patients. In this month’s digital review, we highlight some essential applications. Mobile office apps Maintaining a virtual office is key to keeping...The conservative assessment and treatment of mixed urinary and anal incontinence in women: a multidisciplinary approach
Mixed urinary incontinence Urinary incontinence (UI) is considered to be a highly prevalent condition; however, depending upon the definitions used, actual reported prevalence rates can vary significantly. The International Consultation on Incontinence (ICI) review [1], reported unadjusted prevalence estimates for...
