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Demanding cases or nightmares in uro-oncology? Jan/Feb 2023

Radical surgical treatment of prostate cancer has become minimally invasive owing to robotic assisted laparoscopic technology [1]. Patients who undergo robotic assisted radical prostatectomy (RARP) often have lower risk of morbidity compared to an open approach. However, patients with a...

Ejaculatory dysfunction: a review of current practice and guidelines

Introduction The ejaculatory process is paramount to procreation in nature. It is a complex orchestration of physiology that results in emission of the ejaculate into the posterior urethra followed by ejection of those fluids from the urethra and orgasm. The...

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...

Improving on the Rotterdam Prostate Cancer Risk Calculator

Following the PROMIS trial [1], many cancer centres in the UK are now offering pre-biopsy multiparametric MRI (mpMRI) for men suitable for radical treatment. The European Association of Urology for Prostate Cancer (PCa) guidelines recommend individual risk stratification before the...

PREDICT Prostate – individualised, evidence-based estimates of survival and treatment benefit

Earlier this year ‘PREDICT Prostate’ was launched online alongside a high-profile publication in PLOS Medicine. The prognostic model and decision-aid has been designed to inform treatment decision-making among men newly diagnosed with non-metastatic prostate cancer. David Thurtle and Vincent Gnanapragasam...

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...

Prostate cancer

Case 1 A 65-year-old man is referred to your two-week wait (2WW) clinic with a PSA of 7.0ng/mL. He has no lower urinary tract symptoms (LUTS), no past medical history, no family history of prostate cancer (PCa) and his performance...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

Prostate cancer series: diagnostics 2

- Click here for Part 1 - A 68-year-old male was referred to the two-week wait prostatic clinic with a serum prostate specific antigen (PSA) of 17. He had no bothersome lower urinary tract symptoms, relevant past medical history or...

Biomarkers in prostate cancer detection

Prostate cancer (PCa) is the second most common cancer in men with an estimated prevalence of 1.1 million worldwide in 2012. This heterogeneous disease resulted in approximately 307,000 deaths, making it the fifth leading cause of cancer-related death in men...

In conversation with Roger Kirby

We were delighted to catch up with Roger Kirby, new President of the RSM, about his illustrious career in urology. Can you tell us a little bit about what led you into the field of urology and what have been...

The role of embolisation in urology

Case 1 An 86–year–old male presented with visible haematuria and suprapubic pain. He had a history of diabetes, heart failure, benign prostatic hypertrophy, aortic valve replacement, deep vein thrombosis (DVT) and atrial fibrillation (AF) and was anticoagulated on a non-VKA...