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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...
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...
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...
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...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...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...
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...
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...
