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Preoperative risk stratification of high-risk prostate cancer patients

High-risk prostate cancer (HRPCa) is associated with a significant risk of recurrence after radical treatment. While several classification systems exist, the D’Amico criteria – based on clinical T stage ≥T2c, prostate specific antigen (PSA) ≥20 ng/mL, or Gleason score (GS)...

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...

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...

Digital Twins: From NASA to the clinic

Clinical practice generates an enormous amount of patient data – histories, observations, blood results, imaging and molecular biomarkers. The problem is that these data streams rarely talk to each other. Instead, we use them in isolation, when what we actually...