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Reducing the burden of NMIBC: outpatient laser management in morbid patients
With non-muscle invasive bladder cancer (NMIBC) posing a significant burden on urological departments, alternative ways of safely and effectively managing these patients with a minimally invasive approach is desirable. As rates of recurrence are high but progression rates low, and...Advanced renal tumours
Case 1 A 67-year-old gentleman underwent a CT scan after presenting with visible haematuria and weight loss. His comorbidities include hypertension, type II diabetes mellitis and hypercholesterolaemia. He is a smoker. Figure 1. Figure 2. What do Figures 1 and...Lasers in benign prostatic hyperplasia
Clinical benign prostatic hyperplasia (BPH) impacts on the quality of life of many men. It is intimately related to ageing, but exact calculations of its prevalence remain difficult since an accurate clinical definition still eludes us. Histological BPH has been...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...
Refluxing ureteral reimplantation
Obstructed megaureters may be managed with temporising stents, cutaneous ureterostomies, or in older children with ureteral reimplantation (usually if the child is over one year of age). Cutaneous ureterostomies have risks of stomal stenosis, infection and leakage problems over nappies...
Imaging and Intervention in Urinary Tract Infections and Urosepsis
Urinary tract infections (UTIs) are highly prevalent in the community and account for approximately 40% of hospital-acquired infections. Yet, they are often underestimated and under-diagnosed: as one chapter of this book is entitled, nothing is simple about acute pyelonephritis. This...
Abiraterone acetate in men with castration-resistant prostate cancer
With emerging results from the Stampede and Latitude studies, abiraterone has taken the forefront in the management of metastatic prostate cancer while researchers try to identify the ideal timing for administration. It is a potent inhibitor of CYP17 which results...
Prognostic impact of preoperative neutrophil-to-lymphocyte ratio after radical prostatectomy
Neutrophil-to-lymphocyte ratio has been shown to be a prognostic factor in a number of different cancers. This is one of the largest studies to date to evaluate its effect on overall survival in patients who have undergone radical prostatectomy (RP)...
PET imaging of prostate-specific membrane antigen in prostate cancer
Molecular imaging utilising prostate-specific membrane antigen (PSMA) as a target has increasingly been mentioned at key conferences and meetings. PSMA is a membrane metalloenzyme that is overexpressed in prostate cancer, with the degree of expression appears to correlate with tumour...
Predicting bone scan positivity in non-metastatic CRPC
There is evidence that suggests that early treatment with chemotherapy, immunotherapy or hormone therapy leads to a better response in patients with asymptomatic metastatic castrate resistant prostate cancer (CRPC). This study aimed to predict bone scan positivity in patients with...
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...
