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ICS updates in continence care: the role of the nurse continence specialist in continence services

The nurse who specialises in continence care is recognised as a key member of interdisciplinary teams seeking to deliver high quality integrated continence services. The recently published international service specifications for continence care [1] supports the use of specialist continence...

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...

MRI screening for prostate cancer: a step towards a ‘prostagram’

The UK National Screening Committee has been calling for further research into alternative screening tests for prostate cancer. The committee decided against prostate cancer screening using prostate specific antigen (PSA) testing on the basis that “PSA is still a poor...

Medical statistics for urologists: part 2 – probability and hypothesis testing

Following on from Part 1 of this series (Part 3 available here), this article aims to build on other analytical techniques commonly used within medical research, focusing on simple examples. Probability and testing Before exploring hypothesis testing, it is vital...

Diving into unfamiliar water – volunteering in critical care

On the 14th and 15th floor of The Royal London Hospital lay rows of patients infected with COVID-19 battling for their lives at The Queen Elizabeth unit. In response to the pandemic, the hospital rapidly expanded their critical care facility...

Priapism in sickle cell disease

What is sickle cell disease? Sickle cell disease (SCD) is one of the most common single-gene disorders in the UK affecting approximately one in every 2000 live births. Approximately 20-25 million people worldwide have SCD. It predominately affects those of...

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...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

Use of MRI in the evaluation of prostate cancer: part 2

Diffusion weighted imaging and contrast enhanced imaging Introduction Magnetic resonance imaging (MRI) is widely used in localisation, staging and post-treatment follow-up of prostate cancer. In the previous issue, we discussed the usefulness of MRI in depicting prostate anatomy and pairing...

Lifestyle interventions for UI in women

Lifestyle interventions for urinary incontinence (UI) are supported by all major guidelines. The National Institute for Health and Care Excellence (NICE) guideline (CG171) from September 2013 (updated November 2015) [1] recommends lifestyle advice including dietary modifications such as caffeine reduction,...