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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...

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...

How do we tackle social injustice in urological cancer?

Socioeconomic status as an established determinant of health and associated injustices is well recognised. Confronting these injustices and creating a fairer healthcare system is an ongoing challenge for many governments. In Scotland, the devolved government has created the Scottish Index...

Rotterdam Prostate Cancer Risk app

The widespread use of prostate specific antigen (PSA) testing has led to diagnostic difficulties for patients and urologists. The sensitivity and specificity characteristics of PSA are far from optimal. To try and improve the predictive accuracy of PSA measurements, nomograms...

Urolithiasis – metabolic considerations

Case 1 A 32-year-old female patient is diagnosed with a ureteric calculus for the first-time. What type of metabolic evaluation investigations should be performed? When should stone analysis be repeated? What are the most common metabolic abnormalities associated with calcium...

In conversation with Jo Cresswell

We were delighted to catch up with Jo Cresswell, Vice-President of BAUS, about her career highlights and views on urology in general. Can you tell us a little bit about what led you into the field of urology and what...

Demanding cases or nightmares in uro-oncology? Sep/Oct 2021

Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...

Using cryopreserved prepubertal testis tissues – are we getting warmer?

The rising incidence of childhood cancer coupled with increasing survivorship means there is a growing population of childhood cancer survivors with unmet health needs. In the UK around 1 in 500 children and young people are survivors of childhood cancer....

Frailty in urology – part 1

Part 2 of this topic can be found here Statement of the problem Clinical frailty carries an increased risk of poor health outcomes. The pathological process resulting in frailty is often overlooked and elucidating its aetiology and natural history are...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

Overview of partial nephrectomy techniques: influence of technology

Traditionally, radical nephrectomy was the preferred operation for kidney cancer, while partial nephrectomy was reserved for specific circumstances and essential indications such as a tumour in a solitary kidney, bilateral kidney tumours, or severe chronic kidney disease (CKD). Given the...

Nocturia – the Cinderella of lower urinary tract symptoms

Nocturia is defined as waking during the night (at least once) to urinate. The important part of the definition relates to the necessity of sleep to precede the episode (although whether sleep must follow the episode is less clear). The...