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The assessment and medical treatment of LUTS secondary to BPH
The term benign prostatic hyperplasia (BPH) describes prostate enlargement due to non-cancerous processes. Several aetiological mechanisms are involved, including hormonal and vascular alterations; abnormal regulation of apoptosis; and prostatic inflammation, which may stimulate cellular proliferation. With ageing, prostate enlargement can...
Transurethral enucleation is superior to resection for the management of LUTS secondary to BPH
This meta-analysis (Level 1b evidence) examined the efficacy and safety of two primary transurethral therapies used in the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), enucleation (HoLEP – holmium laser enucleation of prostate, ThuLEP,...
The role of dutasteride in the prevention of clinical progression in asymptomatic BPH
Following the old adage ‘prevention is better than cure’, this Canadian group performed a post hoc analysis of information gained from the multicentre Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study to evaluate whether dutasteride could decrease the incidence...
Prognostic impact of preoperative neutrophil-to-lymphocyte ratio after radical prostatectomy
Neutrophil-to-lymphocyte ratio has been shown to be a prognostic factor in a number of different cancers. This is one of the largest studies to date to evaluate its effect on overall survival in patients who have undergone radical prostatectomy (RP)...
Predicting bone scan positivity in non-metastatic CRPC
There is evidence that suggests that early treatment with chemotherapy, immunotherapy or hormone therapy leads to a better response in patients with asymptomatic metastatic castrate resistant prostate cancer (CRPC). This study aimed to predict bone scan positivity in patients with...
Prostatic urethral lift for obstructive median lobes: 12-month results of the MedLift study
As the various new BPH therapies try and mark out their role in the management of the condition, this is an interesting and useful addition to the literature. Patients were clinically screened for an obstructive median lobe on cystoscopy, which...
BPH therapy: how to find one’s way through the maze?
This communication is from the Young Academic Urologists (YAU) group of the European Association of Urologists (EAU). A purpose-built questionnaire of current practice was sent to 2000 members, of which 637 responded (68% were aged 50 or younger). Alpha blockers...LUTS update
Case study A 70-year-old, generally fit and well male attends your outpatient clinic. He has experienced a gradual deterioration in his voiding over the last few months. Specifically, he reports hesitancy, poor flow and nocturia. He denies visible haematuria. His...
Prostatic calculi and CIC
Although the clinical importance of prostate calculi has been debatable, it is a disease that can cause a plethora of symptoms and signs – sometimes in disguise. Clean intermittent catheter (CIC) is the gold standard method for bladder rehabilitation /...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...
Prostatic urethral lift provides good alternative to TURP for men with LUTS
Lower urinary tract symptoms (LUTS) due to prostatic enlargement resulting in bladder outflow obstruction are common. Transurethral resection of the prostate (TURP) remains the gold standard in operative management, however it is not without its risks. In this multicentre European...
