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A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

Why bother? Metabolic screening for stone formers

Introduction Despite the considerable increase in the incidence of stone disease in the UK and elsewhere in recent years, urologists have engaged with preventative strategies to only a limited degree. With mounting evidence of the strong correlation between obesity and...

Andrology (2020)

Case 1 What is the diagnosis based on the blood test, and how is the diagnosis made? What additional blood tests are required? What are the clinical manifestations of this? What are the options / modes of delivery for treatment?...

Sexual dysfunction following prostate cancer treatment

Prostate cancer is common with over 52,300 new cases diagnosed annually in the UK; this is expected to rise by 15% between 2023-2025 and 2038-2040 [1]. Radical prostatectomy continues to be the most common form of radical treatment for men...

Neuromodulation for lower urinary tract dysfunction – an ICS update

Non-invasive and invasive electro-stimulation techniques have been extensively studied in the treatment of lower urinary tract and bowel dysfunction, including overactive bladder syndrome (OAB), non-obstructive chronic urinary retention, faecal incontinence and chronic pelvic pain. Currently, the most common indication for...

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...

ICS updates on continence care: making sense of detrusor underactivity and the underactive bladder

Countless epidemiological studies have established the frequent occurrence of lower urinary tract symptoms (LUTS) and the significant burden these symptoms incur. For the most part of the past three decades, there has been an overwhelming focus on detrusor overactivity (DO)...

In conversation with Nadine Coull

We were delighted to chat to Nadine Coull, the new President of the Royal Society of Medicine Section of Urology about her career so far and aims for the year ahead. Can you tell us a little bit about what...

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...

Disconnect between clinical trials and real-world oncology patients

Clinical trials are essential to advancing cancer treatment, providing the evidence needed to approve new therapies and improve patient outcomes. However, the strict eligibility criteria used – especially in prostate cancer trials – often exclude real-world patients. These criteria prioritise...

The future of bladder-sparing therapy is bright

Trimodal therapy (TMT), combining optimal transurethral resection of bladder tumour (TURBT) and concurrent chemoradiotherapy, has garnered significant attention for managing muscle-invasive bladder cancer (MIBC). This approach offers the potential for bladder preservation while delivering oncological outcomes comparable to radical cystectomy....

Is antibiotic prophylaxis warranted in hypospadias repairs?

Hypospadias repair is a common paediatric urological procedure. Complication rates following hypospadias repair are variable (ranging from 5–10% for distal hypospadias repairs and as high as 32–70% for proximal repairs). Limiting surgical site infections by minimising infection through antibiotic prophylaxis...