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Tissue-based biomarkers steering clinical decisions in patients with urothelial cancer

Biomarkers play an essential role in the diagnosis and treatment of urothelial cancer (UC), with PD-L1, FGFR, and MMR proteins being the most clinically established. These biomarkers, derived from histological specimens, guide therapeutic decisions for bladder cancer (BCa) and upper...

Mentorship and its role in surgical training

Is there a principle which could help address multiple challenges in surgical training? One which has potential to improve recruitment and retention of staff to our specialty, quality of patient care and surgeon morale? The author discusses the past present...

Medical expulsive therapy for paediatric urolithiasis

Children who have kidney stones are likely to have recurrences. Many initial stones are treated conservatively allowing for spontaneous passage of small stones if possible. Doxazocin or tamsulosin are known to dilate the ureter and allow spontaneous passage of stones...

Is Retzius-sparing prostatectomy the way forward?

Urinary incontinence is a common complication of conventional robot-assisted radical prostatectomy (RARP). Retzius-sparing RARP is performed through the pouch of Douglas to avoid destroying the pelvic fascia and the prostate’s anatomical structures. It has shown early favourable results in terms...

Post radical nephrectomy presenting with skull metastasis

We present the case of an 83-year-old female who underwent right radical nephrectomy for renal cell carcinoma (RCC). Despite negative surgical margins, the patient presented with a skull metastasis six years post radical nephrectomy. This case highlights the importance of...

Still Getting It Right First Time (GIRFT) in urology: meeting the challenges presented by COVID-19

Back in 2019, Simon Harrison – the then sole national lead for the urology workstream in the Getting It Right First Time (GIRFT) programme – wrote an article for Urology News on the GIRFT national report and how its recommendations...

Optimising weight loss advice in obese women with urinary incontinence: a review

Background The National Institute for Health & Care Excellence (NICE) guidance specifies that women with a body mass index (BMI) of over 30, combined with urinary incontinence or overactive bladder, should be advised to lose weight [1]. A BMI over...

Male genital mysteries

Every now and then urologists are asked to give an opinion on genital lesions and rashes. This article from University College Hospital London is certainly worth a read. Most conditions are benign but some are precancerous leading to penile cancer...

Simple cystectomy for benign disease

In the UK, due to cancer reorientation programmes by the NHS, radical cystectomies happen only in regional cancer centres. But there is no reason why simple cystectomies cannot take place in district general hospitals, often much closer to patients and...

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...

New therapy for overactive bladder

Overactive bladder (OAB) is a complex symptom that can adversely affect quality of life. So far pharmacotherapy has focused on anti-cholinergic drugs. Recently, beta-adrenoreceptors have been identified as having an effect on the detrusor muscle and urothelium. Beta-3 is the...

Use of bone windows in urological CT

Introduction Unenhanced computed tomography of kidneys, ureter and bladder (CTKUB) is the recommended gold standard investigation in patients with acute renal colic. CT urography is now a commonly used technique in the investigation of haematuria, for surgical planning and for...