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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...
Multiparametric MRI with targeted-only biopsy – a new standard?
In this issue of European Urology, Kasivisvanathan et al. present a meta-analysis of two randomised trials comparing prebiopsy MRI with targeted biopsy (TBx) alone versus standard transrectal ultrasound-guided biopsy (TRUS-Bx) in biopsy-naïve men at risk of prostate cancer. Their findings...
The cost of bladder cancer: what can be done?
The rising cost of cancer care is a growing concern for health systems. A 2020 study estimated Europe’s annual cancer-related expenditure at €199 billion, with €109 billion attributed to healthcare costs. Bladder cancer (BC), in particular, imposes a significant financial...
The case against omitting systematic biopsy in younger men
In this issue of European Urology, Al-Monajjed et al. report findings from the PROBASE trial, which evaluated prostate cancer (PC) detection in men aged 45–50 years with PSA ≥3ng/ml using both MRI-targeted biopsy (TBx) and systematic biopsy (SBx). Among 525...
Boosting the immune response to Bacillus Calmette-Guérin
In this issue of European Urology, Buisan et al. report early clinical and immunological outcomes of subcutaneous priming with the non-live mycobacterium tuberculosis RUTI vaccine prior to intravesical Bacillus Calmette-Guérin (BCG) in patients with non-muscle-invasive bladder cancer (NMIBC). The phase...
The emerging role of artificial intelligence in endourology
In an editorial written by Miernik, the growing role of artificial intelligence (AI) in urology, particularly in endourology, is critically appraised, with a focus on a novel study by Lu et al. published in this issue of BJUI. Ureteroscopy with...
PARP inhibitors and prostate cancer
The discovery that BRCA1/2-deficient tumour cells are highly sensitive to poly-ADP ribose polymerase (PARP) inhibitors (PARPi) established the foundation of synthetic lethality in metastatic castration-resistant prostate cancer (mCRPC). The TOPARP-A trial confirmed clinical benefit, with PARPi activity largely restricted to...
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...
Using bladder diary data to tailor treatments for night wetting
Primary nocturnal enuresis affects 10–16% of seven-year-old children and has a social, emotional and psychological impact on the affected child. Pathogenesis involves abnormal bladder reservoir function, nocturnal polyuria and an inability to wake up before emptying of the bladder. Desmopressin...
Upper pole access is safe and effective for paediatric percutaneous nephrolithotomy
Upper pole access for percutaneous nephrolithotomy (PCNL) provides a straight access tract to the ureter with easier placement of a guidewire, good exposure of the pelvis and upper ureter, and comfortable manipulations for the treatment of staghorn, large upper caliceal,...
Percutaneous nephrolithotomy: wisdom, dogma, paradigm and myths
A non-transpapillary technique appears to ease access to the kidney – the most critical step in percutaneous nephrolithotomy (PNL) – when compared to the classic transpapillary approach. Remarkably, the earliest descriptions of percutaneous access by Goodwin et al. in 1955...
