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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,...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

Focal therapy trials

Men with localised prostate cancer have traditionally required whole gland treatment involving radical prostatectomy or radical radiation treatment, independent of disease location and size. Increasing evidence supports the use of active treatment only in those men diagnosed with prostate cancer...

PDE5I in LUTS – how do they work – no proof yet

Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

Rectal swab testing before prostate biopsy

This study explored the real terms value of rectal swab testing and targeted antibiotic prophylaxis in patients undergoing transrectal ultrasound prostate biopsy in view of increasing bacterial resistance to fluoroquinolones (17.6% in North America, 40% in Hong Kong). The authors...

Prostate cancer detection rate of MRI-TRUS fusion vs. systematic biopsy

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be considering introducing the technique of magnetic resonance imaging transrectal ultrasound (MRI-TRUS) fusion biopsies to their practice. A retrospective...

What is the significance of prostatic calcification?

This prospective study on men undergoing transrectal ultrasonography (TRUS) biopsies was performed to evaluate the prevalence and to classify prostatic calcification (PCalc) on TRUS and correlate the findings with histology. Images of the prostate were saved at three defined regions:...

Prostate cancer and an electronic nose

So far the transrectal ultrasound guided (TRUS) biopsy has been the ‘gold standard’ for diagnosing prostate cancer. However, it is invasive and can lead to complications, so there is a need for new non-invasive diagnostic tools to avoid unnecessary biopsy...

An overview of changes to urology training

Paediatric urology training A review of paediatric emergency services in the UK involving general surgery, urology and paediatric surgery was initiated due to the problems encountered by the lack of suitable experience outside large paediatric surgical units to deliver emergency...

The life of a urology trainee in Singapore

Despite the political and cultural differences between the United Kingdom and Singapore, the quality and nature of the medical training systems remain uniquely similar. It will come as no surprise to those of you who have either worked in Singapore...

Surgical video – part 1: intraoperative video recording and storage

The use of digital technology has progressed in leaps and bounds and nowhere is this more apparent than in medicine and surgery. Footage of live surgery is now easily accessed on the internet or displayed at conferences. Thus, the 21st...