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Post prostatectomy outcomes of patients with high-risk prostate cancer treated with neoadjuvant androgen blockade

This is an interesting paper reporting on the use of neoadjuvant androgen blockage in patients with high-risk prostate cancer undergoing radical prostatectomy. Previous work in the literature has shown an improvement in the rate of organ-confined disease and decreased positive...

The natural history of prostate cancer on MRI

Multiparametric MRI features heavily on a number of active surveillance protocols. This study looked at 86 men on active surveillance who had an mpMRI prior to 2013 to assess how lesions changed over time. Two blinded radiologists examined all the...

Vitamin D and LUTS

Lower urinary tract symptoms (LUTS) and vitamin D deficiency have been thought to be connected, but the association has been inconsistent. Vitamin D receptors have been identified in the bladder, prostate and pelvic floor muscles, and it has been linked...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Ejaculatory dysfunction and the treatment of LUTS

For years ejaculatory dysfunction in men following medical or surgical treatment of lower urinary tract symptoms (LUTS) was thought to be a result of disruption of the bladder neck mechanism and the subsequent retrograde flow of semen. Men commenced on...

Small renal masses – diagnosis and management

Renal cancer is the eighth most common cancer in the UK and accounts for about 3% of all new cancer diagnoses [1]. The incidence rates are steadily rising, with the highest rates being in older men and women. This rise...

Testicular cancer: management of stage I seminoma

Introduction Testicular cancer is the most frequently occurring solid tumour in men between the ages of 15 and 34 years [1]. About 60% of cases are seminomas and approximately 70-80% of them have, at presentation, clinical stage I disease. This...

Molecular biology – bladder cancer

Background Bladder cancer is the most common cancer of the urinary tract and approximately 90% of bladder cancers diagnosed in North America and Europe are transitional cell carcinomas (TCC). For the purposes of diagnosis and treatment, bladder cancer is often...

Demanding cases or nightmares in uro-oncology? May/Jun 2022

Delayed diagnosis of testicular cancer Testicular cancer is considered rare in the general population but is the most common cancer affecting males between 24 and 49 years. The diagnosis of testicular cancer depends on physical examination, ultrasound findings and tumour...

Bladder carcinoma MRI

Bladder malignancy is one of the commonest malignancies of the renal tract, accounting for approximately 6% of male malignancy and 2% of female malignancy. The incidence increases with patient age with 70% of patients being over the age of 65...

Practising surgery in a war zone: an interview with Dr Volodymyr Melnyk

It is now nine months since the full-scale Russian invasion of Ukraine commenced in late February 2022, with Putin announcing a “special military operation” to “denazify and demilitarise” Ukraine. The rest of the world, however, saw it for what it...

Comparison of PCNL under spinal versus general anaesthesia

There are several advantages of performing percutaneous nephrolithotomy (PCNL) under spinal anaesthesia including lower cost, reduced adverse effects and less tracheal tube displacement. Another advantage is that the patient remains awake throughout making positioning easier and reducing the risk of...