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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...
Hypospadias – how long should follow-up be?
The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...Male infertility
Definitions Infertility is the inability of a sexually active, non-contracepting couple to achieve spontaneous pregnancy in one year [1]. About 15% of couples do not achieve pregnancy within one year and seek medical treatment for infertility. Semen parameters are standardised...
Bedside teaching
All of us are involved in the teaching and training of under or postgraduate medical students and nurses. This article gives a patient’s perspective and thoughts on being an ‘interesting’ patient within a ward or clinic setting. Important points to...
Abiraterone plus prednisone in metastatic, castration-sensitive prostate cancer
Abiraterone acetate, the prodrug of abiraterone, blocks endogenous androgen synthesis by inhibiting cytochrome p-450c17, a critical enzyme in androgen biosynthesis. Its active D4A metabolite also has anti-tumour effects through possibly multiple mechanisms. 3-5% of men diagnosed with prostate cancer in...Understanding Stauffer’s syndrome
Who was Stauffer and what is Stauffer’s syndrome? Maurice Stauffer (1915-1994) was a gastroenterologist at the Mayo Clinic in Rochester, United States, and in 1961 first characterised the non-metastatic, paraneoplastic effects of renal cell carcinoma (RCC) on liver size and...
Lichen sclerosus and isolated bulbar urethral stricture disease
The incidence of urethral stricture in men with lichen sclerosus (LS) has been reported to be between 4.8% and 14%. LS limited to the glans and urethral meatus can be treated with acceptable outcomes; however, more extensive urethral disease requires...
The importance of assessing frailty in patients prior to radical prostatectomy
This large-scale retrospective study evaluated the short-term postoperative outcomes in patients with localised prostate cancer treated with radical prostatectomy (RP). Both body mass index (BMI) and Charlson comorbidity Index (CCI) are well established indicators of adverse outcomes post major surgery,...Partial segmental thrombosis of the corpus cavernosum
Epidemiology Partial segmental thrombosis of the corpus cavernosum (PSTCC) is a rare condition and usually presents in young men. Approximately 56 cases have been reported in 34 publications since 1976, when the first two cases were described [1,2]. The mean...Urological Complications of Malignancy
Case 1 1. What does this sagittal magnetic resonance imaging (MRI) scan show? 2. Which cancers commonly cause this? 3. What is the acute management? Case 2 1. What is the diagnosis? 2. What local effects can this mass cause?...Hard flaccid syndrome
Chronic pelvic pain is defined as pain present below the level of the umbilicus with a duration of more than six months [1,2]. Chronic pelvic pain syndromes (CPPS) are highly prevalent in Western society, affecting both males and females. Studies...
