The edition · Urology
A year of supervised exercise and diet advice improved quality of life and fatigue in men on androgen deprivation
The STAMINA trial embedded a lifestyle programme in routine NHS cancer care for 700 men. Plus why a normal kidney ultrasound does not rule out reflux after a child's first UTI, nerve sparing in high-risk prostatectomy, and three-year results for intravesical gemcitabine-docetaxel.
The edition in brief
In the STAMINA trial across 15 English NHS trusts, 700 men on androgen deprivation therapy were randomised to a 12-month programme of supervised aerobic and resistance exercise, dietary advice, behavioural support and gym membership, or to optimised usual care. At 12 months the programme improved prostate cancer quality of life (FACT-P, 4.5 points) and fatigue (FACIT-F, 1.9 points), with three intervention-related serious adverse events, all resolved. A meta-analysis of 90 studies informing the 2026 American Academy of Pediatrics UTI guideline found renal and bladder ultrasound detected vesicoureteral reflux with sensitivity of only 50% and specificity of 71% after a first UTI, and no better for high-grade reflux. In a single-centre cohort of 1,385 robotic prostatectomies, nerve sparing in men with two or more high-risk features was not linked to worse margins or 12-month biochemical recurrence, and these men used fewer pads at a year. A single-arm phase 2 trial of 25 BCG-naive high-risk non-muscle-invasive bladder cancers treated with intravesical gemcitabine and docetaxel reported high-grade recurrence-free survival of 80% at three years. The pearl covers the history to take in a child with recurrent UTI.
After a child's first UTI, a normal kidney ultrasound missed half of reflux
A normal kidney ultrasound after a child's UTI does not exclude reflux; decide on further imaging by recurrence and risk.
Nerve sparing in high-risk robotic prostatectomy was not linked to worse early cancer outcomes
With structured planning, nerve sparing in selected high-risk men was not linked to worse early cancer outcomes.
Intravesical gemcitabine-docetaxel kept 80% of BCG-naive high-risk bladder cancers free of high-grade recurrence at three years
Gemcitabine-docetaxel is a reasonable option when BCG is unavailable; it has not been shown equal to BCG.
In a child with recurrent UTI, ask about bowels and bladder habits first
In a toilet-trained child with recurrent UTI, look for and treat bowel and bladder dysfunction first.
Supervised exercise and diet support improved quality of life and fatigue on androgen deprivation therapy
Refer men on androgen deprivation therapy to supervised exercise with dietary support; it improved quality of life and fatigue.
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