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The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

Recent developments in bladder cancer

There have been some exciting developments in bladder cancer over the last few years. Immunotherapy has prolonged survival in a proportion of patients with metastatic disease, with sustained efficacy in some. Advances in genetic analysis and molecular subtyping make personalised...

Urinary biomarkers for surveillance of non-muscle invasive bladder cancer

Bladder cancer (BC) is the ninth most common cancer worldwide with a yearly incidence of approximately 430,000 cases. There is a male predominance and it is the seventh most common cancer in men worldwide [1]. Non-muscle invasive bladder cancer (NMIBC)...

Prostate cancer

Case 1 A 65-year-old man is referred to your two-week wait (2WW) clinic with a PSA of 7.0ng/mL. He has no lower urinary tract symptoms (LUTS), no past medical history, no family history of prostate cancer (PCa) and his performance...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

Urethral pain syndrome – is there a light at the end of the tunnel?

Urethral pain syndrome (UPS) is defined in the 2014 EAU Guidelines as the occurrence of chronic or recurrent episodic pain perceived in the urethra, in the absence of proven infection or other obvious local pathology. UPS is often associated with...

Technology – Part 2

Case 1 Name the machine shown in the picture and describe how it works. What is the standard frequency of ultrasound waves in this machine? What frequency of ultrasound waves are utilised in an abdominal and scrotal ultrasound? Case 2...

The surgical management of female stress urinary incontinence in a post-mesh era

Trends in surgical management of women with stress urinary incontinence (SUI) have changed in recent times, mainly due to the ‘High Vigilance Pause’ placed on the use of mesh for SUI (and prolapse) surgery in July 2018 following an independent...

The NICE Guideline on Urinary Incontinence: the management of urinary incontinence in women

Background Urinary incontinence (UI) is a common symptom that can affect women of all ages. It is difficult to estimate the prevalence of UI since it is often under-reported, although the Norwegian EPINCONT study looking at women over 20 reported...

Sexual dysfunction following prostate cancer treatment

Prostate cancer is common with over 52,300 new cases diagnosed annually in the UK; this is expected to rise by 15% between 2023-2025 and 2038-2040 [1]. Radical prostatectomy continues to be the most common form of radical treatment for men...

Retropubic versus transobturator mid-urethral slings for stress incontinence

Mid-urethral slings are commonly used in the surgical management of stress urinary incontinence. This multicentre, randomised trial aimed to compare the safety and efficacy of the retropubic tension-free vaginal tape (TVT) with the transobturator tension-free vaginal tape (TVT-O) in a...

Update on immunotherapy for non-muscle invasive transitional cell carcinoma of the bladder

Patients with high-risk non-muscle invasive bladder cancer (NMIBC) that have failed Bacillus Calmette-Guérin (BCG) treatment are a difficult group to treat, and many may not be suitable for the preferred treatment option of radical cystectomy. Bladder-preserving treatments for BCG-unresponsive high-risk...