Highlights for Patients from the 2026 European Association of Urology Congress (EAU26)

The annual congress of the European Association of Urology (EAU) is one of the main scientific meetings at which new research in urology is shared. The 41st congress (EAU26) was held in London on 13–16 March 2026. The EAU’s 2026 guideline updates were published in the same period. In this article we summarise, in plain language, the topics from the congress studies and guideline updates that directly concern patients.

An important reminder: some of the results presented at the congress are early results and have not yet been peer reviewed. For this reason, not every innovation means a method that is used straight away in everyday practice.

What was discussed about prostate cancer screening?

The congress press release highlighted several studies on prostate cancer screening, including:

• 30-year results of the Göteborg 1 screening study in Sweden: In this study, which began in 1994 and included 20,000 men, it was reported that in the group invited to screening, one death from prostate cancer was prevented for every 311 men over 15 years and for every 161 men over 30 years. In other words, the benefit of screening increases over time. On the other hand, it was emphasised that cancers that would never have caused any problems were also detected (overdiagnosis).
• Risk-based assessment (PRAISE-U): Preliminary results from five European pilot centres showed that when PSA density or a risk calculator was used after PSA, referrals for MRI fell by 40–60%.
• A blood test with multiple biomarkers: In an organised screening programme in Sweden, using this type of blood test before MRI in men with a PSA of 2 ng/mL or higher was reported to reduce MRI scans by 67% and biopsies by 40%.
• The effect of screening on anxiety: In the Göteborg 2 study, worry was common among men who were found to have a raised PSA and were referred for MRI and biopsy, but severe anxiety was rare.

For details, see the prostate cancer page and our article what does a raised PSA mean?

Can PSMA PET reduce biopsies in men with an equivocal MRI?

At a special session on the first day of the congress, the results of the PRIMARY2 study from Australia were presented. The study included 660 men who had not had a biopsy before and whose MRI result was equivocal (PI-RADS 3), or of low suspicion but with risk factors (PI-RADS 2). One group went straight to biopsy, while the other group first had a PSMA PET/CT scan; only those with a suspicious area on PET had a biopsy.

About half of the men in the PET group (49%) were able to avoid a biopsy. The detection rate of significant cancers was 12% in the PET group and 16% in the direct biopsy group, and the difference stayed within the acceptable margin set in advance in the study; diagnoses of low-risk cancer not needing treatment fell from 32% to 14%. Long-term follow-up is ongoing, and PSMA PET is not readily available at every centre. We cover the topic in detail in our article on what is new in prostate cancer diagnosis.

Which route is recommended for prostate biopsy?

The 2026 EAU guidelines on prostate cancer and urological infections give a strong recommendation for prostate biopsy to be performed by the transperineal route, through the skin of the perineum (the area between the scrotum and the anus), on the grounds of a lower risk of infection and more rational use of antibiotics. They also include a weak recommendation that preventive antibiotics may be omitted for transperineal biopsy in patients without risk factors for infection. We describe how the procedure is done in our article on how a prostate biopsy is done.

What has changed for urinary tract infections?

In the 2026 urological infections guideline, the recommendations on the diagnosis and treatment of cystitis were updated, a new section on fungal urinary tract infections was added, and antibiotic doses were reviewed. The guideline recommends discussing with women options that reduce antibiotic use in the treatment and prevention of cystitis.

At the American Urological Association (AUA) meeting held in Washington on 15–18 May 2026, an observational analysis covering more than 57,000 women reported that recurrent urinary tract infections were less common among those following a vegetarian diet. This shows an association, not evidence of cause and effect. Details are on our urinary tract infection page and in our article on the 2026 guideline update.

What does the guideline on urinary symptoms in men say?

In the guideline on lower urinary tract symptoms in men, the strength of recommendation for beta-3 agonist medicines, used for storage symptoms (frequent urination, a sense of urgency), was updated; the guideline gives these medicines a strong recommendation in men with moderate to severe symptoms. A new management pathway was added for detrusor underactivity, in which the bladder muscle contracts weakly, together with a new section on voiding disorders in young men.

At the congress, two randomised trials (COMPaRE from the Netherlands and MultICath from the UK) were also presented, showing that in patients who use intermittent self-catheterisation, catheters that can be washed and reused were not worse than single-use catheters in terms of urinary tract infection. For details, see the enlarged prostate treatment page and our article on the 2026 update on urinary symptoms in men.

What updates were made in sexual health?

In the sexual and reproductive health guideline, the sections on testosterone deficiency, ejaculatory disorders, penile curvature and priapism were updated. For Peyronie’s disease, the guideline lists injection of hyaluronic acid into the plaque in the acute phase to reduce pain and/or curvature as a weak recommendation, noting that outcome data are still limited.

It was also reported at the congress that a 12-week, app-based digital behavioural therapy for premature ejaculation improved ejaculation time and satisfaction in a small randomised trial of 80 patients. Approaches of this kind are still new and need to be confirmed in larger studies.

What stood out in testicular cancer and kidney stones?

In testicular cancer, a multicentre study presented in a special session examined whether serial measurement of a blood marker called microRNA-371 in patients with stage I disease could improve diagnostic accuracy and show relapse earlier. Although this marker is promising, publication of the detailed results is still awaited; it has not replaced standard follow-up.

In the 2026 guideline on kidney stone treatment, the sections on renal colic, medical expulsive therapy, preventive antibiotics for shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy were revised.

When should you see a urologist?

Congress and guideline news provides a general framework; personal decisions are made on the basis of examination, test and imaging results. It is advisable to see a urologist if your PSA is raised, if you have burning when passing urine, frequent urination or a weaker urine flow, if you have recurrent infections, or if you have noticed penile curvature or problems with erections or ejaculation. Bringing your previous test and imaging reports with you makes the assessment easier.

Op. Dr. Mücahit Kabar sees patients in Bursa (Nilüfer), Turkey, at Özel Medicabil Nilüfer Hastanesi (weekdays 08:30–12:00, +90 444 8 112) and Özel Jimer Hastanesi (weekdays 13:00–17:00, +90 444 45 67). Appointments are booked through the hospitals’ online booking pages or appointment lines. Consultations are held in English or Turkish; the hospitals’ international patient departments can arrange interpreters for other languages. If you are travelling from abroad, you can send your questions and reports by WhatsApp to +90 541 622 54 82 before your visit. See the contact and appointment information for details.

Sources

• EAU26 Highlights: Day 1 – Uroweb
• EAU26 highlights: Day 4 – Uroweb
• Research presented at international urology conference in London shows how far prostate cancer screening has come – EAU press release
• Scan that makes prostate cancer cells glow could cut need for biopsies – EAU press release (PRIMARY2)
• PSMA PET-CT Scan Reduces Need for Prostate Cancer Biopsies – The ASCO Post
• EAU Guidelines on Prostate Cancer 2026 – Summary of changes
• EAU Guidelines on Urological Infections 2026 – Summary of changes
• EAU Guidelines on Management of Non-neurogenic Male LUTS 2026 – Summary of changes
• EAU Guidelines on Sexual and Reproductive Health 2026 – Summary of changes
• EAU Guidelines on Sexual and Reproductive Health 2026 – Full text (PDF)
• EAU Guidelines on Urolithiasis 2026 – Summary of changes
• Single-Use vs Reusable Catheters for Intermittent Catheterization in Patients With Urinary Retention: The COMPaRE Randomized Clinical Trial (JAMA Netw Open 2026) – UroToday
• Review of the European Association of Urology (EAU) Congress 2026 – European Medical Journal
• Research Highlights Diet and Hormone Therapy Advances in Preventing Recurrent UTIs in Women – AUA press release