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Prostate cancer management 1 – non-metastatic disease
You are referred a 68-year-old gentleman to the rapid access prostate clinic with a serum prostate specific antigen (PSA) of 12ug/L. He is otherwise fit and well with mild voiding lower urinary tract symptoms (LUTS). He undergoes a multi parametric...
Solifenacin for children and adolescents with overactive bladders
Solifenacin (VESIcare®) is the second-line anti-muscarinic medication of choice for my patients with overactive bladder (oxybutynin being my initial choice). However, currently, it remains unlicensed for use in children. Newgreen et al. have evaluated the long-term safety and efficacy of...
Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer
Despite prostate cancer being one of the most commonly diagnosed cancers worldwide, there remains a need for high-quality evidence regarding the optimal treatment choice. In this large population-based cohort study, using the PCBaSe Sweden dataset, Sooriakumaran and colleagues identified patients...
Solifenacin and mirabegron are safe and effective in combination
Antimuscarinic agents remain the mainstay of medical management of bladder overactivity. Limited somewhat by their tolerability, the new agent mirabegron, a β3-adrenoreceptor agonist, has been approved as an alternative. There is little known however about the possible synergistic effects of...Adrenal incidentalomas: what next?
An incidentaloma refers to an adrenal lesion >1cm discovered incidentally during radiologic examination. Identifying a malignant and / or functioning lesion is critical for management. However, as the majority of lesions are benign, the challenge is the identification of malignant...
Botox® instillation into the bladder
Patients with refractory overactive bladder (OAB) may be offered OnabotulinumtoxinA (Botox®) as one of the third-line options. Given the invasive nature of requiring cystoscopy, injections via a needle and local anaesthesia, it would be simpler, more convenient and more accessible...
Refining management of non-visible haematuria
The optimal evaluation of non-visible haematuria (NVH) continues to be debated, with competing interests of avoidance underdiagnosis and the harms of over-testing. Current National Institute for Health & Care Excellent (NICE) guidance recommends referral for patients ≥60 years with NVH....
Prostate cancer screening
This editorial is from the University of Minnesota in the USA. The present evidence suggests that prostate specific antigen (PSA) testing provides a small reduction in prostate cancer (CaP) mortality and no reduction in all-causes mortality. The downside is of...
