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Multiparametric MRI with targeted-only biopsy – a new standard?
In this issue of European Urology, Kasivisvanathan et al. present a meta-analysis of two randomised trials comparing prebiopsy MRI with targeted biopsy (TBx) alone versus standard transrectal ultrasound-guided biopsy (TRUS-Bx) in biopsy-naïve men at risk of prostate cancer. Their findings...
The cost of bladder cancer: what can be done?
The rising cost of cancer care is a growing concern for health systems. A 2020 study estimated Europe’s annual cancer-related expenditure at €199 billion, with €109 billion attributed to healthcare costs. Bladder cancer (BC), in particular, imposes a significant financial...
The case against omitting systematic biopsy in younger men
In this issue of European Urology, Al-Monajjed et al. report findings from the PROBASE trial, which evaluated prostate cancer (PC) detection in men aged 45–50 years with PSA ≥3ng/ml using both MRI-targeted biopsy (TBx) and systematic biopsy (SBx). Among 525...Testicular cancer (Mar 2015)
Case 1 What does the ultrasound show? What further imaging does this patient require? Which tumour markers should be checked? What is the half-life of these markers? What does an elevation in these markers mean? Case 2 What is this...Upper Tract Developmental Abnormalities
Case 1 1. What is the abnormality and how common is it? 2. What is the embryological origin? 3. With what other conditions can this be associated? Case 2 1. What is the diagnosis and how common is it? 2....So you want to be a urologist?
Urology is a varied, innovative and friendly speciality and it is easy to see why so many people are attracted to it. The article below is designed to help all doctors wishing to apply for an ST3 post get the...An inconvenient truth: reflections on the NHS
“What gets us into trouble is not what we don’t know. It’s what we know for sure that just ain’t so.” The above is a quote attributed to Mark Twain from the 2006 documentary, An Inconvenient Truth, which follows Al...
Ureterocystostomy – novel surgery for the paediatric obstructed megaureter
Megaureter is a relatively common congenital urinary tract anomaly; obstructed non-refluxing megaureter is one variant. Initial management is conservative, with operative intervention reserved for symptomatic cases (recurrent pyelonephritis, pain, increasing dilatation or worsening renal function). Surgical options include cutaneous ureterostomy,...
Transfer to tertiary paediatric hospitals for patients with testicular torsion
Although this articles comes from a tertiary centre in Columbus, USA, there are similarities with the current controversies in the UK. The authors carried out a five-year retrospective review looking at the surgical transfer of 125 patients (mean age 13.4,...
Performance of non-invasive tests in diagnosing BOO in men with LUTS
A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...
