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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...

Sir Eric Riches’s cystoscope

In this series of articles I am going to show you some of the exhibits contained in the Museum of Urology, hosted on the BAUS website (www.baus.org.uk). In the last history article we came across Sir Henry Morris, former President...

Characteristics of testicular tumours in prepubertal children

It is well known that testicular tumours in children occur in one of two peaks. Firstly, in the first four years of life where a third to half of these tumours are benign and secondly during puberty where there is...

Testicular masses – can the testis be spared?

The standard practice for testicular masses confirmed on ultrasound has been to offer an inguinal orchidectomy, on the presumption that the mass represents testicular cancer. The growing use of scrotal ultrasound for various indications has led to an increase in...

Urological Complications of Malignancy

Case 1 1. What does this sagittal magnetic resonance imaging (MRI) scan show? 2. Which cancers commonly cause this? 3. What is the acute management? Case 2 1. What is the diagnosis? 2. What local effects can this mass cause?...

What to expect when meeting a statistician

There are a growing number of statisticians working closely with medics from all specialties. They have different training but they are driven by the same goal: to perform high quality evidence-based clinical research [1,2]. In a perfect world we would...

Ketamine uropathy – an update

The first two case series that documented the association between urinary tract damage and recreational ketamine use were published 12 years ago [1,2]. Since then ketamine has maintained a controversial profile as an essential medication of expanding utility but with...

Nocturia – the Cinderella of lower urinary tract symptoms

Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...

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...

The Kennedy Report

Context The death of George Floyd at the hands of racist driven police brutality in May 2020 shook the world into a period of civil unrest and active demonstration against unacceptable discrimination displayed by people of authority. The Black Lives...

Is AS in SRM more convincing than in prostate cancer?

This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...

MRI of the Prostate: A Practical Approach

The MRI is a non-negotiable part of prostate cancer diagnosis and management. As a result, this book is an essential. This nicely illustrated and well written account covers aspects ranging from MRI protocols, through Prostate Imaging Reporting and Data System...