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What is the role of evidence-based medicine in urology?
The concept of ‘evidence-based medicine’ (EBM) was first developed in the early 1990s and was described as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients” by the recently...
Testosterone and erectile function – the debate goes on!
The most common causes of erectile dysfunction (ED) as per European Association of Urology (EAU) guidelines are: psychogenic, vasculogenic, neurogenic and hormonal. The EAU 2017 guidelines recommend measuring total testosterone (TS) level. This study is a meta-analysis of 14 randomised...Clinical Trials 2 – key papers
Clinical Trials 1 is available here. Case 1 This British study on haematuria clinic diagnostic yield was published in the British Journal of Urology International in 2006. The results are often asked in examinations! Edwards TJ, et al. A prospective...Focal therapies in prostate cancer
The standard of care in the management of prostate cancer has, to date, always been to treat the whole gland. This has ranged from surveillance, surgical excision / prostatectomy or external beam radiotherapy / whole gland brachytherapy. With the evolution...
Management of Prostate Cancer: A Multidisciplinary Approach
This is an excellent textbook which comprehensively covers the vast field of prostate cancer. The editors, who have co-ordinated phase III European Organisation for Research and Treatment of Cancer (EORTC) trials, have brought together a large array of well-known international...
Reliability of grading of VUR and other findings on VCUG
The gold standard for diagnosing VUR is still the voiding cycstogram (VCUG). These authors looked at the inter observer variability of grading of vesicoureteral reflux (VUR) using a VCUG and highlight the implications for treatment and prognosis as a results....
Mindfulness-based stress reduction as a novel treatment for IC/PBS
Interstitial cystitis / painful bladder syndrome (IC / PBS) is not fully understood and is associated with significant morbidity. The objective of this study was to provide initial data to evaluate mindfulness-based stress reduction (MBSR) as a treatment for IC...
Tolerability and persistence in women prescribed mirabegron
Mirabegron is a beta-3 agonist used in the treatment of overactive bladder (OAB). Trials have shown reduced side-effects but equal efficacy when compared to anticholinergics. The authors wished to examine patients’ persistence with treatment, in a non-trial setting, over a...
Can antibiotics reduce ‘unnecessary’ prostate biopsies?
With numerous factors capable of influencing prostate specific antigen (PSA) levels and therefore the likelihood of biopsy, this multi-centred randomised controlled trial (RCT) was designed to see if two weeks of ciprofloxacin compared to placebo would significantly reduce PSA levels...
Which is better – laparoscopic or open paediatric pyeloplasty?
In an attempt to answer the above question, Gatti et al. undertook a randomised controlled trial between 2005 and 2014. All children aged 1 to 18 years of age requiring surgery for pelviureteric junction (PUJ) obstruction were enrolled. A total...
