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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...

Medical statistics for urologists: part 3 – diagnostic testing

Following on from the first two parts of this series (see Part 1 here, and Part 2 here), this final article aims to demonstrate how the theory of statistics applies to medical diagnostics. Probability in diagnostic testing Diagnostic tests refer...

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 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...

Developing and validating a new nomogram for diagnosing BOO in women

Bladder outlet obstruction (BOO) in women is thought to be present in between 2.7% and 27%. Causes of BOO in women may be anatomical or functional. Yet, unlike the diagnosis in men, there is no standard definition for BOO in...

Why bother? Metabolic screening for stone formers

Introduction Despite the considerable increase in the incidence of stone disease in the UK and elsewhere in recent years, urologists have engaged with preventative strategies to only a limited degree. With mounting evidence of the strong correlation between obesity and...

Fertility Focus

Fertility Focus: Male Factor Fertility Forum 2020 A deep-dive into the management of male fertility issues in the field of urology, expertly sub-edited by Jonathan Ramsay. Supplement Co-ordinating Editor Jonathan Ramsay: “These authoritative reviews explore what urologists are able to...

Prostate Cancer Diagnosis – PSA, Biopsy and Beyond

The danger of many of the texts which deal with this rapidly changing field is that by the time the texts are published they are out of date. This book however remains fresh, in part because it acknowledges that there...

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...

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...

The PROMIS trial – time for multi-parametric MRI before a first prostate biopsy

Whilst the relatively random process of 12 core transrectal ultrasound guided (TRUS) prostate biopsy remains by far the most widely employed approach to prostate cancer diagnosis in the UK, its flaws as a standalone diagnostic strategy are increasingly apparent. TRUS-biopsy...