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Is TRUS and biopsy obsolete as a diagnostic test for prostate cancer: refining the perineal biopsy technique?

Whilst there has been a dramatic shift in how patients are investigated for potential prostate cancer, transrectal ultrasound (TRUS) and biopsy remains the most commonly used technique for tissue sampling. In this single centre, retrospective analysis, 634 men, over a...

New concepts, emerging technologies and potential therapeutics in testicular torsion

This review article is worthy of reading in its entirety. It addresses current concepts in the management of one of the few paediatric urological emergencies. For every 100,000 males <25 years, 4.5 will have testicular torsion per year. Given that...

Penile augmentation using injectable filler

Penile size is a major topic for many men and a source of anxiety throughout history. The common belief that a large penis is necessary to impress and satisfy their sexual partners has led to the notion that ‘bigger is...

The assessment and medical treatment of LUTS secondary to BPH

The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...

Urinary incontinence in women – part 2: management

In the second part of our comprehensive overview of urinary incontinence (UI) the authors explore the plethora of treatment options for this complex condition. (Part 1 available here). Conservative management Initial treatment of incontinence should be conservative. Caffeine reduction and...

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...

The origins of urinary stone disease

This is a descriptive paper of micro CT scans of tubular mineralisation in 12 nephrectomy specimens. The authors noted that: in the small number of specimens examined, mineralisation started in the outer medulla and appeared to proceed distally along the...

Post-prostatectomy incontinence

Urinary incontinence following prostate surgery (post-prostatectomy incontinence or PPI) is a significant complication that can have a profoundly negative impact on the quality of life of patients suffering with it. It may become a barrier to physical activity and social...

The workplace environment and doctors’ health

It is well established that doctors have higher levels of stress, depression and suicide than the general population [1] and most other professional groups. In addition they have high levels of ‘burnout’. Research indicates that although burnout is correlated with...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

An overview of non-surgical treatment options for Peyronie’s disease

Peyronie’s disease (PD) is a therapeutic challenge despite the availability of several non-surgical and surgical options. Very few of these options are supported by good quality evidence according to the current American and European guidelines [1-3]. The period of plaque...

New techniques in UTI diagnosis

Urinary tract infection (UTI) is a common reason for seeking medical care in both primary and secondary settings. Half of women will have at least one episode of cystitis in their lifetime, and a third of them will have experienced...