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The medical management of LUTS/BPH – an update

For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...

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...

Establishing a new TPPBx service during the COVID-19 pandemic

COVID-19 had a major impact on our hospital services from early in the pandemic, with almost three times as many patients being ventilated compared to the normal ITU capacity at the beginning of April. During the build-up to this point,...

PDE5I in LUTS – how do they work – no proof yet

Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...

Focal therapy for prostate cancer – ready for prime time?

The current therapeutic ratio for radical therapy in many men with localised prostate cancer is not ideal. For a significant side-effect profile, there seems to be a small survival benefit over a 10-15 year period. A strategy that might balance...

Demanding cases or nightmares in uro-oncology? Sep/Oct 2021

Active surveillance for prostate cancer: missing the boat Case In 2005 a 43-year-old man of Afro-Caribbean ethnicity was referred to our centre for investigation of suspected prostate cancer. Digital rectal exam revealed a firm right lobe, PSA of 2.3ng/ml, prostate...

Rectal swab testing before prostate biopsy

This study explored the real terms value of rectal swab testing and targeted antibiotic prophylaxis in patients undergoing transrectal ultrasound prostate biopsy in view of increasing bacterial resistance to fluoroquinolones (17.6% in North America, 40% in Hong Kong). The authors...

Prostate cancer detection rate of MRI-TRUS fusion vs. systematic biopsy

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be considering introducing the technique of magnetic resonance imaging transrectal ultrasound (MRI-TRUS) fusion biopsies to their practice. A retrospective...

What is the significance of prostatic calcification?

This prospective study on men undergoing transrectal ultrasonography (TRUS) biopsies was performed to evaluate the prevalence and to classify prostatic calcification (PCalc) on TRUS and correlate the findings with histology. Images of the prostate were saved at three defined regions:...

Prostate cancer and an electronic nose

So far the transrectal ultrasound guided (TRUS) biopsy has been the ‘gold standard’ for diagnosing prostate cancer. However, it is invasive and can lead to complications, so there is a need for new non-invasive diagnostic tools to avoid unnecessary biopsy...

Getting it Right First Time in urology: the implementation phase

The Getting it Right First Time (GIRFT) programme is the largest and most comprehensive initiative to improve the quality and efficiency of individual clinical services that the NHS has ever instigated. The programme falls under the auspices of NHS Improvement...

Male urethrograms

An ascending urethrogram is the best initial radiographic technique to image a male patient’s urethra and is indicated for strictures, fistulae, trauma and urethral obstruction [1]. It is quick and straightforward to perform and is performed using an 8Fr Foley...