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The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

NICE backs laser for BPH

Benign prostatic hyperplasia affects 60% of men aged 60 or over. The medical technology division of the National Institute for Health & Care Excellence (NICE) has supported the GreenLight XPS laser system as a surgical tool. The specific indications are:...

Durability and complications of photoselective vaporisation of the prostate with GreenLightTM

Alternatives to the standard transurethral resection of the prostate (TURP) in the management of bladder outflow obstruction due to prostatic hypertrophy are becoming more common. In this retrospective case series, the outcomes of 117 patients undergoing GreenLightTM lithium triborate photoselective...

Cardiac failure and medical therapy for LUTS / BPH

Alpha blockers (AB), 5-alpha reductase inhibitors (5-ARI) and combination therapy are widely prescribed for lower urinary tract symptoms (LUTS) considered consequent to prostatic enlargement and are the mainstay of first-line therapy. This retrospective interrogation of a large population-based dataset of...

Clear cell urothelial carcinoma: a highly aggressive morphological variant in the bladder and upper urinary tract

Clear cell urothelial carcinoma (CCUC) is a rare morphological variant of transitional cell carcinoma (TCC). It can occur anywhere along the urothelial tract and is characterised histologically by high grade carcinoma with an abundance of clear, glycogen-rich cytoplasm [1]. Alternative...

Prostate cancer

Case 1 What is prostate specific antigen (PSA) and what is its function? According to the ERSPC Trial (at 13 years), what was the number needed to screen and diagnosed to prevent one prostate cancer death and what was the...

Hypercalciuria in children with monosymptomatic nocturnal enuresis

Nocturnal enuresis, defined as intermittent urinary incontinence, regardless of the presence or absence of daytime symptoms, is common. Monosymptomatic nocturnal enuresis – MSNE (no daytime symptoms) has four main causes identified with it: poor vasopressin action, nocturnal polyuria, poor arousal...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

Anti-VEGF and PD-1 combinations in renal cell carcinoma

Over the past decade, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors (TKIs) have been central to treating renal cell carcinoma (RCC), with oncologists refining dosing strategies to balance treatment efficacy with quality of life (QoL). Recently, the introduction of...

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...

Urology ST3 interview update and top tips

This article, written by a Urology ST3 from the West of Scotland Deanery, aims to give the reader an insight into the ST3 interview process along with some helpful hints for those about to undertake the challenge. The aims of...

Predictors of vaginal mesh exposure after mid-urethral sling placement

Vaginal mesh exposure following mid-urethral sling (MUS) insertion can be a difficult complication to treat. The aim of this study was to identify possible risk factors in patients who had unfortunately developed vaginal mesh exposure following MUS surgery. This was...