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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...

Sepsis syndrome in urology

There are approximately 100,000 cases of sepsis per year in the UK, of which 37,000 result in death (this is more than prostate cancer, breast cancer, HIV / AIDS and road traffic accidents combined). Urosepsis is defined as sepsis caused...

HIV / AIDS – implications for the urologist

“It’s no fun to have HIV even though it’s viewed as a chronic, controllable disease. It means being wedded to the health system.” - Philip Berger, Associate Professor in the Department of Family and Community Medicine, Toronto, Canada; and leading...

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...

Men with a susceptibility to prostate cancer: implications of family history in PCa risk-prediction

Incorporation of family history (FH) status into prostate cancer (PCa) risk stratification has the potential to underpin many aspects of PCa care. This group of men presents a unique challenge in early cancer detection, particularly given that most men without...

The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

Prostate artery embolisation

Introduction Benign prostatic hyperplasia (BPH), a common condition associated with ageing, affects 50% of those between the ages of 50 and 60 years, and as many as 90% of those older than 80 years. BPH is characterised by unregulated, benign...

Balanitis xerotica obliterans

Balanitis xerotica obliterans (BXO) / lichen sclerosus of the male genitalia is a common cause of acquired phimosis, and was first described by Stuhmer in 1928 [1]. It is described in medical literature as a chronic inflammatory condition of unknown...

Mesh in urological surgery in the UK – background, reviews and current status

All UK urologists, unless they have been on a 10-year silent retreat, are by now aware of the controversy surrounding surgical use of mesh in general and urological / urogynaecological use of mesh for the surgical treatment of stress urinary...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

Urinary biomarkers for surveillance of non-muscle invasive bladder cancer

Bladder cancer (BC) is the ninth most common cancer worldwide with a yearly incidence of approximately 430,000 cases. There is a male predominance and it is the seventh most common cancer in men worldwide [1]. Non-muscle invasive bladder cancer (NMIBC)...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...