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Cardiac failure and medical therapy for LUTS / BPH

Alpha blockers (AB), 5-alpha reductase inhibitors (5-ARI) and combination therapy are widely prescribed for lower urinary tract symptoms (LUTS) considered consequent to prostatic enlargement and are the mainstay of first-line therapy. This retrospective interrogation of a large population-based dataset of...

Demanding cases or nightmares in uro-oncology? Jan/Feb 2023

Radical surgical treatment of prostate cancer has become minimally invasive owing to robotic assisted laparoscopic technology [1]. Patients who undergo robotic assisted radical prostatectomy (RARP) often have lower risk of morbidity compared to an open approach. However, patients with a...

Performance of non-invasive tests in diagnosing BOO in men with LUTS

A large proportion of urology involves the treatment of bladder outflow obstruction (BOO) in men. Yet BOO in men is very difficult to accurately quantify with the only regular non-invasive test being uroflowmetry. Pressure flow urodynamics may be considered the...

Use of MRI in the evaluation of prostate cancer: part 1

Introduction Prostate cancer remains the most commonly diagnosed cancer in males and the second leading cause of cancer related deaths in UK men, after lung cancer [1]. The incidence of prostate cancer in the UK has shown a rapid increase...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...

MRI screening for prostate cancer: a step towards a ‘prostagram’

The UK National Screening Committee has been calling for further research into alternative screening tests for prostate cancer. The committee decided against prostate cancer screening using prostate specific antigen (PSA) testing on the basis that “PSA is still a poor...

Bladder outlet obstruction

Case 1 Define the zonal anatomy of the prostate: A, B and C What is the significance of Zone A and Zone C? Clasify the types of lower urinary tract symptoms (LUTS) Which investigations should be routinely undertaken for a...

Lasers in urology

1. What does LASER stand for? 2. What elements are involved and how is a LASER created? 3. The following cases involve laser surgery. Can you diagnose the pathology, identify which type of lasers can be used, and their wavelengths?...

The EP2 receptor – a novel target for prostate cancer?

This basic science paper sets out to evaluate the effects that celecoxib, a selective cyclo-oxygenase-2 (COX-2) inhibitor, have on prostate cancer cell lines and evaluated the mechanisms behind these effects. COX-2 induces the production of prostaglandins, which promote cell proliferation...

Are urodynamics still useful?

Two major UK randomised controlled trials, UPSTREAM and FUTURE, compared comprehensive clinical assessment (CCA) alone with CCA plus urodynamics (UDS), incorporating filling cystometry and pressure–flow studies. Both trials involved patients in whom diagnostic uncertainty suggested a potential role for UDS...

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...

Consensus statements on PSA testing in asymptomatic men in the UK

In January 2016, the UK National Screening Committee once again recommended against a systematic population screening programme for prostate cancer due to the, as yet, insufficient evidence that the benefits of screening would outweigh the harm to the population as...