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Recent advances in the management of castration resistant prostate cancer

Castrate resistant prostate cancer (CRPC) is defined by disease progression despite androgen-deprivation therapy lowering testosterone to castrate levels. It may present as a rise in serum levels of prostate specific antigen (PSA), progression of pre-existing disease, or the appearance of...

Can antibiotics reduce ‘unnecessary’ prostate biopsies?

With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...

Urolithiasis 4 - Staghorn calculus

Case scenario A 64-year-old woman with recurrent urinary tract infections and left flank pain undergoes investigations as an outpatient. Figure 1a. Figure 1b. 1. Describe Figures 1a and 1b. 2. Her co-morbidities are type 2 diabetes (which is well controlled)...

BPS – a diagnostic enigma

This article from a London teaching hospital presents the results of a Medline search about challenges in bladder pain syndrome. All the known definitions from the American Urological Association (AUA), European Association of Urology (EAU), etc. are given while the...

Beta 3 receptors in OAB

More and more is written on Beta 3 receptors in human bladders and their role in detrusor relaxation. This study from Japan investigated human Beta 3 AR gene which is polymorphic. One hundred women with overactive bladder (OAB) and 101...

BJN Urology Study Day

British Journal of Nursing (BJN) is delighted to launch the BJN Urology Study Day, part of a new series of expert-led educational events taking place in London every other month. Developed in collaboration with the British Association of Urological Nurses...

Prostatic artery embolisation versus sham

Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...

Active surveillance for small renal masses in younger patients

Active surveillance (AS) is discussed as an option for renal masses <2cm in patients with significant competing risks for mortality. This multicentre data from the US seeks to fill an important gap in current guidelines for provision of this option...

ESWL and URS for treatment of paediatric urolithiasis

Tejwani et al. have undertaken a comparative effectiveness study to characterise differences in procedure frequency, postoperative re-admissions and emergency room (ER) visits, and repeat treatment rates for children (≤18 years) with urolithiasis who underwent initial intervention with extracorporeal shock wave...

Vitamin B12 deficiency in patients after enterocystoplasty

It is well known that enterocystoplasty within terminal ileum leads to vitamin B12 deficiency and regular monitoring of this post-surgery is essential. Often supplements need to be given because of deficiency in up to 40% of patients. These authors looked...

Redo orchidopexy

Cryptorchidism, or the undescended testis, is perhaps the most common genital anomaly in males. Historical success rates are approximately 90% depending on the preoperative location and technique used. Iatrogenic cryptorchidism can also occur in up to 2% of cases following...

Hypospadias – detecting your complications

All hypospadias surgeons will encounter complications. They are estimated to occur in around 10% of distal hypospadias repairs and more than 50% for proximal forms. Some controversy exists regarding the length of follow-up needed to detect them. Some series have...