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Prostate cancer management 2 – metastatic disease
A 72-year-old gentleman is referred to you in the two-week wait clinic with a prostate specific antigen (PSA) of 22ug/L. He is otherwise fit and well and does not take any regular medication. His multi-parametric magnetic resonance imaging (mpMRI) shows...
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...
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...
How can we reduce morbidity after RARC with intracorporeal neobladder?
Robot-assisted radical cystectomy (RARC) is a complex procedure with high postoperative morbidity, especially when combined with neobladder reconstruction, which has a higher complication rate compared to other urinary diversions. To minimise these complications, it is crucial to understand their nature...
Five-year outcomes following negative MRI or biopsy in the RAPID diagnostic pathway
The Rapid Assessment for Prostate Imaging and Diagnosis (RAPID) pathway was introduced in UK urology centres to streamline prostate cancer diagnosis using an MRI-directed approach. Men with elevated PSA undergo upfront multiparametric MRI (mpMRI), and biopsy is reserved for those...History of prostate biopsy – part 1
Part 2 of this topic is available here. Prostate biopsy (PBx) to exclude cancer has been part of clinical practice since the beginning of the 20th Century. PBx techniques have evolved over time to optimally address some of the unique...25 Years of Prostate Cancer UK
As leading men’s health charity, Prostate Cancer UK, celebrates its 25th anniversary, top researchers reflect on the huge progress in testing, treatment and support for men over the past 25 years. 25 years of beating prostate cancer together Matthew Hobbs,...Intravesical glycosaminoglycan analogue instillations for recurrent cystitis
Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....
