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Biomarkers in prostate cancer detection

Prostate cancer (PCa) is the second most common cancer in men with an estimated prevalence of 1.1 million worldwide in 2012. This heterogeneous disease resulted in approximately 307,000 deaths, making it the fifth leading cause of cancer-related death in men...

Understanding gender differences in nephrolithiasis

Rates of nephrolithiasis are higher in males than females. The cause for this remains unclear, however animal models have demonstrated an association between sex steroid hormone levels and lithogenesis. This relationship in humans is less well established. This study from...

The doctor as the patient: receiving bad news

This article, written by a GP working in the NHS, gives a unique insight into the experience of being a urology patient and some thoughtful advice on ‘breaking bad news’. Day 1 Alarm bells ring. It’s spotting an email from...

LUTS among Caucasian-European men who have sex with men: findings from a real-life survey

This study is the first of its kind to report an association between men who have sex with men (MSM) and lower urinary tract symptoms (LUTS). Nine hundred and forty-nine consecutive individuals who presented to a uro-andrology clinic for complaints...

Vitamin D and LUTS

Lower urinary tract symptoms (LUTS) and vitamin D deficiency have been thought to be connected, but the association has been inconsistent. Vitamin D receptors have been identified in the bladder, prostate and pelvic floor muscles, and it has been linked...

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...

A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

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...

Morbidity and mortality after surgery for LUTS

The market for bladder outflow obstruction surgery is currently wide open with new technologies such as Urolift® emerging. One of the key selling points of new technologies is the comparative safety and efficacy compared to traditional techniques such as transurethral...

Evaluation of the learning curve for learning MRI-US fusion prostate biopsies

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be implementing MRI-US transrectal or transperineal fusion biopsies to their clinical practice. This prospective cohort study evaluated 779 consecutive...

Is Retzius-sparing prostatectomy the way forward?

Urinary incontinence is a common complication of conventional robot-assisted radical prostatectomy (RARP). Retzius-sparing RARP is performed through the pouch of Douglas to avoid destroying the pelvic fascia and the prostate’s anatomical structures. It has shown early favourable results in terms...

Infections and inflammation: Part 1

See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...