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Management of stage 1 non-seminomatous germ cell tumours

Testicular cancer (TC) is the most successfully treated solid tumour, achieving a cure rate of 90-95% [1-3]. Testicular cancer is relatively rare with an incidence of 2207 cases in the UK in 2014 [4] and yet is the most common...

PIRADS-3 lesions and clinically significant prostate cancer – what are we missing?

The use of pre-biopsy MRI has definitely enhanced our decision making in managing patients with suspected prostate cancer (PCa). There is still uncertainty around the outcomes for patients with PIRADS-3 lesions, with a small but definite risk of missing clinically...

Penile cancer: a practical approach

Penile cancer is rare and accounts for less than 1% of all new cancer cases in males in the UK, with around 640 new cases diagnosed every year [1]. In England and Wales, the annual incidence is between 1.2 and...

Non-urologist non-physician assessment of scrotal pain using the TWIST score

Testicular torsion is a urological emergency that requires prompt diagnosis and intervention. Some providers are becoming increasingly dependent on ultrasound (US) to make the diagnosis. This NIH clinical trial evaluated the use of the TWIST (Testicular Workup for Ischaemia and...

New study shows UK may finally be ready for prostate cancer screening

Prostate Cancer UK study shows tens of thousands fewer men each year face unnecessary harm thanks to new screening techniques. New research by Prostate Cancer UK shows that the UK may finally be in a position to roll out a...

Renal masses

Case 1 A 70-year-old female presented under the medical team with malaise, weight loss, and deranged liver function tests (LFTs) and calcium (ALP 350, GGT 650, Serum bilirubin 29, normal aminotransferases, Ca 3.3). An abdominal ultrasound scan (USS) was performed...

Radiological appearances of renal vascular anatomical variants

The purpose of this article is to explain and illustrate common renal vascular variants that can be depicted with imaging. Renal vessels commonly present a wide range of variations [1]; before major renal or vascular surgery is undertaken, accurate portrayal...

Focal therapies in prostate cancer

The standard of care in the management of prostate cancer has, to date, always been to treat the whole gland. This has ranged from surveillance, surgical excision / prostatectomy or external beam radiotherapy / whole gland brachytherapy. With the evolution...

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...

All biochemical recurrences are equal, but some are more equal than others

Despite significant technological advancements, radical prostatectomy (RP) and radiotherapy (RT) are not always effective in curing localised prostate cancer (PCa). Many patients experience a rise in prostate-specific antigen (PSA), known as biochemical recurrence (BCR), leading to considerable anxiety and a...

Chronic retention – all you need to know

Chronic retention – all you need to know Chronic urinary retention is a common presentation in elderly and frail patients. Two types should be recognised - low pressure chronic retention (LPCR) and high pressure chronic retention (HPCR). Acute-on-chronic retention occurs...

MRI targeted transperineal prostate biopsy: a local anaesthetic approach

Transperineal template biopsy remains the gold standard investigation in diagnosis of prostate cancer. Data from the PROMIS study demonstrated the low sensitivity of transrectal ultrasound (TRUS) biopsy as a diagnostic tool, and highlighted the need for a better diagnostic pathway....