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What is the role of evidence-based medicine in urology?
The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...
RN or PN for small RCCs – the debate continues
This is a retrospective study to evaluate kidney function and overall survival (OS) in patients who underwent partial nephrectomy (PN) and radical nephrectomy (RN) for RCCs <4cm. They looked at 2110 patients who underwent RN/PN for T1a renal cell carcinomas...
Cryotherapy in prostate cancer
This review of the literature aims to summarise what is known in regards to outcomes in patients undergoing cryotherapy in a number of settings: whole gland, salvage and targeted focal therapy. It highlights that more prostate cancers are being diagnosed...
Is routine renal tumour biopsy associated with lower rates of benign histology following nephrectomy for small renal masses?
There has been a considerable increase in the detection of small renal masses (SRM). Approximately 20% of these turn out to be benign lesions on final histopathological analysis. Therefore upfront surgery can be overtreatment in such a group of patients....
To clamp or not to clamp – outcomes of the CLOCK trial for robotic partial nephrectomy
The benefits of partial over radical nephrectomy are well established. The CLOCK trial (CLamp vs. Off Clamp the Kidney during robotic partial nephrectomy) was designed as a multicentre, randomised controlled trial to generate evidence on the role of the off-clamp...
All biochemical recurrences are equal, but some are more equal than others
Despite significant technological advancements, radical prostatectomy (RP) and radiotherapy (RT) are not always effective in curing localised prostate cancer (PCa). Many patients experience a rise in prostate-specific antigen (PSA), known as biochemical recurrence (BCR), leading to considerable anxiety and a...
How to handle the opening market in robotic surgery
In the latest edition of European Urology, Thillou et al. present a groundbreaking case series comprising 10 instances of robotassisted radical prostatectomy (RARP) procedures conducted using the innovative Dexter robotic system by Distalmotion SA, Épalinges, Switzerland. This marks the maiden...
Oncological benefits of extended pelvic lymph node dissection
Touijer and colleagues present extended follow-up results from a large randomised trial comparing limited pelvic lymph node dissection (l-PLND) and extended PLND (e-PLND) in prostate cancer patients undergoing radical prostatectomy. The study aimed to assess whether e-PLND, which includes external...
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...
