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History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Cord compression in cancer

This article will be of great interest to uro-oncologists. Vertebral metastasis occurs in 3-5% of all cancers (most commonly in prostate, breast and lung cancer). It can cause pain, vertebral collapse and cord compression. Data from the National Institute for...

Assessment of the incidental adrenal lesion

Introduction The adrenal glands are seen on CT or MRI surrounded by fat in the peri-renal space. The right adrenal gland lies medial to the right lobe of the liver, lateral to the right crus of the diaphragm and superior...

Prostate cancer

Case 1 What is prostate specific antigen (PSA) and what is its function? According to the ERSPC Trial (at 13 years), what was the number needed to screen and diagnosed to prevent one prostate cancer death and what was the...

Visual-estimation (cognitive), image-fusion (software) and in-bore targeted prostate biopsy: is there an optimal approach?

The diagnostic superiority of multiparametric magnetic resonance imaging (mpMRI) prior to targeted and systematic prostate biopsy over systematic transrectal ultrasound-guided (TRUS) biopsy alone in the detection of clinically significant prostate cancer (csPCa) has been proven by multiple level 1 studies...

Radiological investigation of haematuria in 2016

This paper summarises the current evidence for and use of various imaging modalities for investigating haematuria. The following investigations are reviewed: Intravenous urogram (IVU) – the number of centres still using IVU is decreasing. IVU is cheaper and has less...

The conservative assessment and treatment of mixed urinary and anal incontinence in women: a multidisciplinary approach

Mixed urinary incontinence Urinary incontinence (UI) is considered to be a highly prevalent condition; however, depending upon the definitions used, actual reported prevalence rates can vary significantly. The International Consultation on Incontinence (ICI) review [1], reported unadjusted prevalence estimates for...

Is AS in SRM more convincing than in prostate cancer?

This article reviews active surveillance (AS) in the management of small renal masses (SRM), the role of renal tumour biopsy (RTB), patient selection, tumour growth kinetics, and outcomes. SRMs which are defined as masses ≤4 cm in diameter and enhance...

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...

Prostate cancer series: diagnostics 2

- Click here for Part 1 - A 68-year-old male was referred to the two-week wait prostatic clinic with a serum prostate specific antigen (PSA) of 17. He had no bothersome lower urinary tract symptoms, relevant past medical history or...

Impact of prostatic apex in continence after RARP

This article investigates the impact of prostatic apical shape from preoperative magnetic resonance imaging (MRI) on early recovery of urinary continence after robot-assisted radical prostatectomy (RARP). It is a retrospective study of 1011 patients at a tertiary centre. Patients were...

Penile cancer

Case 1 A 67-year-old man presents with a worsening red patch over the past three months. It looks velvety in some areas. What is the most likely diagnosis? What are the risk factors? How do you classify this condition? How...