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Standard versus expanded cultures to diagnose UTIs in women

Clinicians are well aware of the limitations of the so-called Kass criteria applied to standard urine culture (SUC) techniques as well as the limitations of empiric antibiotic prescribing for symptoms that are known to overlap with chronic conditions such as...

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...

Hypospadias – how long should follow-up be?

The optimal duration of follow-up following childhood hypospadias repair (to detect complications) is ill-defined. Several surgeons recommend it to include assessment during puberty. Some may worry that ‘rapid penile growth’, ‘erectile forces’ and ‘sexual activity’ could potentially stress previously successful...

Prostate cancer detection in younger men

Prostate cancer (PC) screening using prostate-specific antigen (PSA) testing with systematic biopsy (SBx) reduces mortality but risks overdiagnosis and unnecessary biopsies. Multiparametric MRI (mpMRI) enables MRI-targeted biopsy (TBx) of suspicious lesions and is now recommended before biopsy, although its role...

Cryotherapy in prostate cancer

This review of the literature aims to summarise what is known in regards to outcomes in patients undergoing cryotherapy in a number of settings: whole gland, salvage and targeted focal therapy. It highlights that more prostate cancers are being diagnosed...

ICS updates in continence care: a personal perspective on the role of basic science in urology

At a urology research meeting in Sheffield a few years ago, a former post doctorate researcher in urology, Mathieu Boudes, said: “Stop calling it basic research, there is nothing basic about it. It is fundamental research to everything urologists do.”...

The adrenals

Case 1 A 45-year-old man undergoes a CT of his abdomen to stage a newly diagnosed bowel malignancy. What does the scan show? What findings on a CT scan suggest an adrenal lesion is benign? If the CT scan is...

Klinefelter’s syndrome

Klinefelter’s syndrome (KF) is the most frequent sex chromosome abnormality with an estimated prevalence of 1 in 500 to 1 in 700 newborn males and 1 in 10 in men with azoospermia. While the majority of cases are an XXY...

Stuttering (recurrent ischaemic) priapism

Stuttering (recurrent ischaemic) priapism (SP) is a rare urological condition. Affected men will often experience almost daily prolonged and painful sleep related erections (SRE). Interestingly, these men report normal erections during the day and whilst awake. These episodes are usually...

Priapism in sickle cell disease

What is sickle cell disease? Sickle cell disease (SCD) is one of the most common single-gene disorders in the UK affecting approximately one in every 2000 live births. Approximately 20-25 million people worldwide have SCD. It predominately affects those of...

Imaging and Intervention in Urinary Tract Infections and Urosepsis

Urinary tract infections (UTIs) are highly prevalent in the community and account for approximately 40% of hospital-acquired infections. Yet, they are often underestimated and under-diagnosed: as one chapter of this book is entitled, nothing is simple about acute pyelonephritis. This...

Abiraterone acetate in men with castration-resistant prostate cancer

With emerging results from the Stampede and Latitude studies, abiraterone has taken the forefront in the management of metastatic prostate cancer while researchers try to identify the ideal timing for administration. It is a potent inhibitor of CYP17 which results...