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Increasing PSA after negative prostate biopsy - solving the clinical puzzle

There are standard guidelines for first transrectal ultrasonography (TRUS) guided biopsy in a patient presenting with elevated prostate-specific antigen (PSA) or suspicious digital rectal examination (DRE) findings. Patients are generally warned before a TRUS biopsy in respect of a false...

Effect of DUA on surgical outcomes of HoLEP

Lower urinary tract symptoms (LUTS) become increasingly common in men as they age, with over 70–90% of men aged over 80 experiencing these issues. Detrusor underactivity (DUA) is characterised by a weakened bladder contraction, leading to prolonged or incomplete bladder...

Antibiotics and HoLEP

Holmium laser enucleation of the prostate (HoLEP) is an increasingly done size-independent surgical treatment for benign prostatic hypertrophy. There is currently a lack of data on perioperative antibiotic prescribing patterns for HoLEP and thus, no consensus on optimal practices. This...

Richard Wolf Range Update

Richard Wolf a global business with headquarters in Germany and over a century of tradition and expertise in the field of endoscopy. We develop, manufacture and market specific system solutions for minimally invasive human medicine.

Demanding cases or nightmares in uro-oncology? Sep/Oct 2021

Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...

Pacemakers in the upper urinary tract

This is an interesting study from Italy. The mechanism by which urine is transported from the kidney to the bladder via the upper urinary tract (UUT) remains poorly understood and elusive. For many years, pyeloureteric rhythmicity is thought to arise...

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...

Biomarkers in prostate cancer detection

Prostate cancer (PCa) is the second most common cancer in men with an estimated prevalence of 1.1 million worldwide in 2012. This heterogeneous disease resulted in approximately 307,000 deaths, making it the fifth leading cause of cancer-related death in men...

Bladder outlet obstruction

Case 1 Define the zonal anatomy of the prostate: A, B and C What is the significance of Zone A and Zone C? Clasify the types of lower urinary tract symptoms (LUTS) Which investigations should be routinely undertaken for a...

Testicular tumour imaging

Testicular tumours are the most common tumour in young males with a peak incidence seen between 25 and 34 years [1]. The overall incidence is slowly increasing, although the exact reasons for this are uncertain, and there is a greater...

Bladder perforation after augmentation cystoplasty

Delayed bladder perforation is well recognised after augmentation cystoplasty (5-13% of patients) and adult urologists need to be aware of this and identify the best treatment at the time. Mortality rates and re-perforation rates can be up to 25% and...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...