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The survival impact of neoadjuvant hormonal therapy before radical prostatectomy

There is increasing evidence for the role of radical prostatectomy in select patients with T3-T4 prostate cancer (as part of multimodal therapy). This retrospective multicentre study explored the benefit of neoadjuvant hormonal therapy before radical prostatectomy specifically in patients with...

Ejaculatory dysfunction and the treatment of LUTS

For years ejaculatory dysfunction in men following medical or surgical treatment of lower urinary tract symptoms (LUTS) was thought to be a result of disruption of the bladder neck mechanism and the subsequent retrograde flow of semen. Men commenced on...

Prostate alpha-1 receptors: what is new?

This article from the west of Germany will be of interest to many of us who use alpha-blockers for bladder outflow symptoms. The classic model of understanding of alpha receptors has been challenged recently. Further models have been identified, including...

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...

Urethroplasty: a review of indications, techniques and outcomes

Urethral stricture is the most common cause of lower urinary tract obstruction in men aged between 20 and 40, carrying an estimated overall prevalence of 0.5% in the UK [1] and results in around 17,000 hospital admissions annually [2]. Endoscopic...

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...

Surgical treatment of LUTS secondary to BPH

For the vast majority of patients an initial trial of medical therapy for the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is indicated [1]. In a substantial minority of cases however, a surgical intervention...

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...

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...

Testicular prostheses satisfaction

This is a satisfaction survey in 40 patients who had underwent radical orchidectomy and had saline filled testicular prosthesis (TP) over a 3 year period in US, as the silicone implants are not in use since 1995 in US. No...

Smith’s Textbook of Endourology, 2 Volume Set, 4th Edition

Since the founding fathers of endourology first published this textbook in 1996, the surgical vista has been changed unrecognisably by technological advances. Laparoscopic approaches have become commonplace for renal, ureteric, bladder and prostatic surgery, and robotic-assisted techniques have developed with...