Francesca Kum

Objective: To develop and evaluate an artificial intelligence (AI)‐assisted, multimedia journal club model that improves accessibility by transforming scientific articles into on‐demand educational formats distributed through digital platforms. Subjects and Methods: This prospective single‐centre educational evaluation was conducted at King's College Hospital (London). Six AI‐enhanced journal club sessions were implemented between June and September 2025. Peer‐reviewed urology articles were processed using AI‐assisted tools to generate podcasts, slide presentations, short‐form video summaries, question‐and‐answer materials, and visual infographics. Content was distributed through clinician‐facing platforms including YouTube, Spotify, and social media. Two surveys evaluated educational impact: a format‐specific survey completed by 48 participants and a second survey assessing overall perceptions of the AI‐enhanced journal club completed by 19 participants. Results: The AI‐generated podcast was the most preferred format (62.5%), followed by video summaries (16.7%) and slide presentations (8.3%). Participants reported greater engagement compared with traditional journal clubs, with 54.2% selecting the response option ‘much more engaged’. Format‐specific ratings were consistently high, particularly for podcasts (mean [standard deviation, SD] score for engagement 4.6 [0.6] and for clarity 4.8 [0.5]). In the second survey, overall ratings of the AI‐enhanced journal club were high across all domains, including engagement (mean [SD] score 4.8 [0.4]), clarity (mean [SD] score 4.8 [0.5]), time efficiency (mean [SD] score 4.7 [0.6]), and overall preference (mean [SD] score 4.9 [0.3]). Conclusion: An AI‐assisted, multimodal journal club integrating podcasts, slides, and digital dissemination was associated with improved participant‐reported engagement and accessibility. This scalable model supports asynchronous learning and may complement traditional journal club formats in postgraduate medical education.

Ureteric colic constitutes a large proportion of acute hospital attendances, across the UK, putting pressure on urological services. The British Association of Urological Surgeons (BAUS) guidelines indicate that for patients managed expectantly, a clinic review should be undertaken within 4 weeks of presentation. This quality improvement project reports the benefit of a dedicated virtual colic clinic to facilitate an efficient care pathway and reduce patient waiting times. A retrospective cycle analysed patients referred from the emergency department (ED) with uncomplicated acute ureteric colic (excluding those admitted for immediate intervention) over 2 months in 2019. A further cycle was carried out 12 months later following the introduction of a new dedicated virtual colic clinic with updated ED referral guidance. The mean time from ED referral to urology clinic review fell from 7.5 to 3.5 weeks. The percentage of patients reviewed in clinic within 4 weeks increased from 25% to 82%. The mean time from referral to intervention including shockwave lithotripsy and primary ureteroscopy fell from 15 to 5 weeks. The introduction of a virtual colic clinic improved the time to definitive management of ureteric stones for patients managed expectantly as per BAUS guidelines. This has reduced waiting times for both clinic review and stone treatment which has enhanced patient experience within our service.

Introduction: A prospective cohort study comparing peri‐ and postoperative outcomes for patients with predominantly anterior prostate cancer (APC) identified preoperatively against non‐anterior prostate cancer (NAPC) treated via robotic‐assisted radical prostatectomy (RARP).Patients and Methods: Of the 757 RARP's completed between January 2016 and April 2018, two comparative cohorts for anterior and an equivalent group of non‐anterior prostate tumours each consisting of 152 patients were compared against each other. Data were collected on the following variables: patient age; operating consultant; preoperative PSA, ISUP grade, degree of nerve sparing; tumour staging; presence and location of positive surgical margins; PSA density, postoperative ISUP grade; treatment paradigm and postoperative PSA, erectile function, and continence outcomes with 2‐year follow‐up.Results: APCs were found to have significantly lower ISUP grading postoperatively; increased diagnosis via active surveillance over new diagnosis; more frequently undertaken bilateral nerve‐sparing and long‐term poorer continence outcomes at 18 and 24 months postoperatively (p < 0.05). Pre‐ and post‐op PSA levels, erectile function, PSA density, positive surgical margins (PSM), age and tumour staging showed no significant differences between the APC and NAPC cohorts (p > 0.05).Conclusion: The lower ISUP grading could indicate APC as overall being less aggressive than NAPC, whereas the poorer long‐term continence outcomes require further investigating. The non‐significant differences amongst tumour staging, PSA density, preoperative PSA levels and PSM rates suggest that APC may not be as significant as predicted in diagnostic evaluation. Overall, this study provides useful information on the growing literature of anterior prostate cancer. Being the largest comparative cohort study to date on APC post‐RARP, these results indicate the true characteristics of anterior tumours and their functional outcomes to help improve education, patient expectations and management.

Prostate biopsy is the definitive investigation to diagnose prostate cancer. The ideal procedure would be one that offers fast and efficient results safely as an outpatient procedure. Historically, transrectal ultrasound (TRUS) biopsy is considered the gold standard but transrectal biopsy can under-sample the anterior and apical regions of the prostate and is associated with a risk of prostate biopsy-related sepsis, which may require intensive care admission. Transperineal (TP) biopsy addresses the inefficient sampling of TRUS biopsy but historically has been done under general anaesthetic, which makes it difficult to incorporate into timed diagnostic pathways such as the National Health Service (NHS) 2-week cancer pathway. TRUS biopsy has remained the mainstay of clinical diagnosis because of its simplicity; however, the recent development of simpler local anaesthetic transperineal techniques has transformed outpatient biopsy practice. These techniques practically eliminate prostate biopsy-related sepsis, have a shallow learning curve and offer effective sampling of all areas of the prostate in an outpatient setting. The effectiveness of TP biopsy has been enhanced by the introduction of multiparametric MRI prior to biopsy, the use of PSA density for risk stratification in equivocal cases and combined with more efficient targeted and systematic biopsies techniques, such as the Ginsburg Protocol, has improved the tolerability and diagnostic yield of local anaesthetic TP biopsies, reducing the risk of complications from the oversampling associated with transperineal template mapping biopsies. Areas where the literature remains unclear is the optimum number of cores needed to detect clinically significant disease (CSD) in patients with a definable lesion on MRI, in particular, whether there is a need for systematic biopsy in the face of equivocal MRI findings to ensure no CSD is missed. The Covid-19 pandemic has had a profound impact on prostate cancer referrals and prostate biopsy techniques within the UK; prior to the pandemic 65% of all prostate biopsies were TRUS, since the pandemic the proportions have reversed such that now over 65% of all prostate biopsies in the NHS are transperineal.

Escherichia coli (E. coli)-related urosepsis associated with a ureteric stone has been shown to cause a systemic bacteraemia that can spread to other parts of the body. Hematogenous spread of infection is the most common cause of pyogenic spondylodiscitis. A 74-year-old female presented with acute left-sided flank pain and was found to have an obstructing 9 mm distal ureteric stone. After initial management involving ureteric stent insertion, the patient deteriorated and developed an E. coli associated bacteraemia, which proved difficult to treat. Further investigations revealed a subsequent spondylodiscitis, which required a 6-week course of antibiotics and no additional intervention. This case presents the likely association of stone-related bacteraemia, complicated by urinary tract instrumentation leading to spondylodiscitis, and demonstrates the importance of clinicians’ awareness of other causes of unresolving sepsis in an elderly patient.

Introduction: Mentorship programmes enable students to explore different specialties, observe surgeries and participate in audits, whilst helping trainees develop leadership and teaching skills. We developed such a scheme and asked participants to fill out several questionnaires, to assess its benefits and restrictions. Method: We set up a student-led mentorship scheme, pairing 54 medical students with surgeons around London. Students completed questionnaires before, during and after the scheme and mentors completed a post-mentorship scheme feedback questionnaire, with the purpose of measuring the participants’ experience on Likert scales from 1 to 5. Quantitative data analysis was performed to assess trends. Results: In the cohort of students who answered all three questionnaires (n = 34) the biggest improvements seen over the duration of the scheme were ‘exposure to surgery so far in medical school’ and ‘understanding the steps required to improve a surgical portfolio’, with mean values increasing by 1.653 and 1.733, respectively. The main challenges faced were mainly related to time restraints and communication issues. Conclusions: Mentors and mentees can both benefit from a mentorship scheme, but certain variables, such as time constraints and goal-setting, need to be clearly established for both parties. In the future, the scheme would benefit from more guidance and stricter ruling.

The COVID‐19 pandemic is impacting all urological cancer services. On March 19^th the British Association of Urological Surgeons (BAUS) provided pragmatic guidance for prostate cancer diagnostic services (Table 1 ).(1)

Higher blood pressures (mean systolic difference 16.8 mmHg) when compared to matched individuals are already reported in patients with calcium urolithiasis. We present the prevalence of hypertension and renal impairment in patients with cystinuria from our specialist single centre. We analysed our prospective database of adult patients with cystinuria who attend our cystinuria service. This included details of the medical and operative management of their disease. Descriptive statistics were used to analyse and present the data. 120 patients were included with a median age of 40 (19–76) years, 66 were male (55%) and 54 were female (45%). 54/120 patients (45%) were taking medications to prevent stone formation. 78% (94/120) patients reported having undergone one or more stone-related procedure. 59% (55/94) of these having required at least one PCNL or open procedure during their lifetime. Prevalence of hypertension was 50.8% (61/120), and double in males compared to females (62.1% vs. 37.0%, P = 0.0063). Mean baseline creatinine was 88.2 (49–153) µmol/l and eGFR was 77.6 (32–127) ml/min/1.73 m². When categorized by CKD stage, only 24.6% (27% vs. 21%, M vs. F) patients had normal renal function (being an eGFR > 89 ml/min/1.73 m²). 57.6% patients were CKD stage 2 and 17.8% CKD stage 3. Females had a slightly greater incidence of renal impairment. All patients who have previously undergone a nephrectomy (n = 10) or have a poorly functioning kidney (n = 19) have renal impairment (CKD stage 2 or 3). Incidence of hypertension in patients with cystinuria is 51%, with a male preponderance. Only 25% of patients with cystinuria have normal renal function. This highlights the long-term cardiovascular and renal risks that the metabolic effects of cystinuria pose, in addition to the challenges of managing recurrent urolithiasis in a young population.

Introduction Systematic transperineal (TP) and targeted prostate biopsies can be achieved using a freehand access system through perineal punctures, with the potential for reduced morbidity and enabling the procedure under local anesthesia (LA), particularly sepsis. Objectives To evaluate the histopathological outcomes, morbidity and tolerability of freehand TP prostate biopsies using the PrecisionPoint^™ access system under local anaesthetic (LA) in the day surgery and outpatient environments. Methods 176 patients underwent freehand TP prostate biopsies from May 2016 to November 2017. The procedure was carried out either under LA alone or with addition of sedation. MRI scans were reported using PIRADS v2. Tolerability was assessed by the Visual Analogue Score for each procedural stage. Histopathological outcomes and complications were recorded Results Mean age was 65(36‐83)years, median PSA 7.9(0.7‐1374)ng/ml and mean prostate volume 45(15‐157)cc. All cases were carried out under LA alone (160, 90%) or under LA with sedation (16, 9%). The main indication for biopsy was primary diagnosis (88.6%). 91 (52%) patients underwent systematic TP biopsies (mean 24.2cores). Cognitive MRI targeted biopsies alone were performed in 45 (26%) (mean 6.8cores). 40 (23%) patients had standard both systematic and target biopsies (mean 27.9cores). Of the 75 cases who had primary systematic biopsies alone, 46(61%) were positive, 28/46(60.9%) diagnosed clinically significant disease (Gleason >3+4). Pain scores were greatest during LA administration. There were 5 complications (2.8%, Clavien‐Dindo I/II). No patients developed urinary sepsis. Conclusions Freehand TP biopsies using the PrecisionPoint access system is a safe, tolerable and effective method for systematic and targeted biopsies under LA in the outpatient setting. It has replaced transrectal biopsies in our centre and has potential to transform practice.

Multi-parametric MRI (MP-MRI) prior to prostate biopsy is the investigation of choice for an elevated age-related PSA and abnormal digital rectal examination. MP-MRI in combination with transperineal template mapping biopsy has facilitated the development of the concept of targeted biopsies, either cognitively or with software fusion. Urinary retention is a recognised complication of transperineal prostate biopsy, with reported incidence being 1.6–11.4%. We present patient and procedure-related factors, which influence occurrence of urinary retention after transperineal template biopsy.