Journal Reviews
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...
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...
Are urodynamics still useful?
Two major UK randomised controlled trials, UPSTREAM and FUTURE, compared comprehensive clinical assessment (CCA) alone with CCA plus urodynamics (UDS), incorporating filling cystometry and pressure–flow studies. Both trials involved patients in whom diagnostic uncertainty suggested a potential role for UDS...
Why defining and managing DUST matters in endourology
In endourology, defining ‘DUST’ and optimising its management is vital for improving stone-free rates (SFR) and reducing complications. Residual fragments, even those ≤4mm, can act as a nidus for infection, obstruction, and recurrence. Studies have shown that 30% of patients...
Why are urology consultants leaving full-time NHS practice?
The early retirement of experienced doctors in the UK poses a significant challenge to healthcare provision, particularly in urology, where workforce shortages are exacerbated by high attrition rates among both trainees and consultants. While career dynamics in high-income countries have...
Prostate cancer detection in younger men
Prostate cancer (PC) screening using prostate-specific antigen (PSA) testing with systematic biopsy (SBx) reduces mortality but risks overdiagnosis and unnecessary biopsies. Multiparametric MRI (mpMRI) enables MRI-targeted biopsy (TBx) of suspicious lesions and is now recommended before biopsy, although its role...
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...
