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PIRADS-3 lesions and clinically significant prostate cancer – what are we missing?
The use of pre-biopsy MRI has definitely enhanced our decision making in managing patients with suspected prostate cancer (PCa). There is still uncertainty around the outcomes for patients with PIRADS-3 lesions, with a small but definite risk of missing clinically...Simulation-based training of procedural skills: application and integration of educational theories
Educational theories: how familiar are we with these theories and their application in our training? As a Simulation Fellow I have been involved in teaching specific procedural skills and running full immersion simulation sessions. This experience has exposed me to...
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...What can you do NOW to help kidney stone patients?
Given that the pandemic has meant that cancer surgery and treatment has been postponed, what can be done for patients if their condition isn’t life-threatening?
PDE5I in LUTS – how do they work – no proof yet
Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...Mentorship and its role in surgical training
Is there a principle which could help address multiple challenges in surgical training? One which has potential to improve recruitment and retention of staff to our specialty, quality of patient care and surgeon morale? The author discusses the past present...Can we make LATE-presenting posterior urethral valves an EARLIER-treated condition?
What are posterior urethral valves? Posterior urethral valve (PUV) is the most common cause of congenital bladder outlet obstruction (BOO) and renal failure in male children. They were first described by the Italian anatomist Giovanni Battista Morgagni back in the...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...Clinical trials 1
Clinical Trials 2 is available here. Case 1 1. What are the levels of clinical evidence based on the 2009 definitions from the ‘Oxford CEBM’? 2. What is the null hypothesis? 3. What are type 1 and type 2 errors?...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...
