Journal Reviews
Five-year outcomes following negative MRI or biopsy in the RAPID diagnostic pathway
The ‘Two-Week Wait’ (2WW) pathway is central to the NHS cancer strategy, ensuring rapid review of suspected malignancies. For testicular cancer, NICE NG12 advises urgent referral based solely on clinical suspicion (typically a solid, non-transilluminable scrotal mass) without requiring prior...
Robotic vs. open ureteral reimplantation
Ureteral stricture disease is a frequent and complex problem in urological practice, most commonly arising from iatrogenic injury. Although its exact incidence is difficult to determine, reported rates range from 0.3–2.5% following gynaecological surgery, approximately 3% after ureteroscopy, and up...
Evaluating the ‘two-week wait pathway’ for testicular cancer
The ‘Two-Week Wait’ (2WW) pathway is central to the NHS cancer strategy, ensuring rapid review of suspected malignancies. For testicular cancer, NICE NG12 advises urgent referral based solely on clinical suspicion (typically a solid, non-transilluminable scrotal mass) without requiring prior...
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...
Comparison of CHOKAI, STONE and STONE PLUS scores
The prevalence of urinary stones is steadily increasing due to changing dietary habits and living conditions, leading to a significant number of emergency department (ED) visits, primarily for severe pain. While managing pain is crucial, accurate diagnosis remains essential. Non-enhanced...
Accuracy of cognitive vs software-guided MRI-targeted biopsy
The FUTURE randomised trial showed no difference in prostate cancer (PCa) detection between cognitive, in-bore and software guided MRI-targeted biopsy (TBx) techniques, a finding supported by meta-analyses and reflected in European Association of Urology (EAU) guidelines. However, whether any TBx...
Should expert genitourinary pathology review of orchiectomy specimens be mandatory?
This article contains recommendations from the European Association of Urology Guidelines Panel on Testicular Cancer and argues that centralised review of orchiectomy specimens by expert genitourinary pathologists would contribute to better patient management. Accurate pathological assessment is fundamental to the...
FANS f-URS with mPCNL for 2–3cm renal stones
Flexible ureteroscopy (f-URS) has undergone substantial evolution with the introduction of flexible and navigable suction ureteral access sheaths (FANS), expanding its applicability to larger renal calculi. Although mini-percutaneous nephrolithotomy (mPCNL) remains a standard treatment for 2–3 cm renal stones, uncertainty...
The future of bladder preservation for muscle-invasive bladder cancer
Localised muscle-invasive bladder cancer (MIBC) has historically been treated with radical cystectomy (RC), but bladder preservation therapy (BPT) has emerged as a credible and increasingly refined alternative. Early work by Herr in the 1980s demonstrated that radical transurethral resection of...
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...
When can antibiotic prophylaxis be stopped for VUR in children?
Continuous antibiotic prophylaxis (CAP) is the mainstay of treatment and reduces the risk of febrile urinary tract infections (fUTI) in children with VUR. Thus far, there are no clear management guidelines as to whether and when CAP may be safely...
Is transperineal prostate biopsy without antibiotic prophylaxis the new gold standard?
Prostate cancer is the second most diagnosed malignancy among men worldwide. Despite substantial advances in MRI–guided diagnostic pathways, prostate biopsy with histopathological evaluation remains indispensable for definitive diagnosis. Historically, transrectal biopsy (TRBx) has been the standard approach; however, concerns regarding...
