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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...

COVID-19: cancer and corticosteroids

Under the prevailing COVID-19 crisis, this article is well worth reading. The current World Health Organization (WHO) guidance is not to start steroids in cancer cases, but there is no clear evidence of risks with steroids in cancer patients having...

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...

Cleveland Clinic / Imperial College – Antioxidant Online Survey

Professor Ralf Henkel (Imperial College London/University of the Western Cape) and Professor Ashok Agarwal (Cleveland Clinic) are conducting an international online survey on the prescription of antioxidants for infertile patients, and have requested that we invite you to participate in this study.

Bladder cancer: where are we with intravesical therapies?

In the United Kingdom, almost 10,500 new cases of bladder cancer were identified in 2013, with over 5000 deaths in 2012 [1]. Seventy percent of new cases will be non-muscle invasive bladder cancer (NMIBC) at diagnosis and therefore will be...

Intravesical GAG replacement therapies for bladder pain syndrome / interstitial cystitis – an update

The barrier function of the glycosaminoglycan (GAG) layer of the urothelium was identified by Parsons in 1975, and intravesical therapies to treat chronic inflammatory conditions of the bladder were developed soon after. However, the active role of the urothelium in...

Intravesical glycosaminoglycan analogue instillations for recurrent cystitis

Introduction The symptoms of recurrent cystitis can be triggered by inflammatory or infective causes. Bladder pain syndrome (BPS) and bacterial recurrent lower urinary tract infection can both present with symptoms of recurrent cystitis and cause significant morbidity in affected individuals....

Trials offering cytoreductive surgery for men with de novo synchronous metastatic prostate cancer

Life expectancy in men diagnosed with de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) has risen to a median of 4.8 years with upfront systemic agents (such as docetaxel) in addition to standard androgen deprivation therapy (ADT) [1-3]. Within this...

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...

Tamsulosin and spontaneous passage of ureteral stones in children

This was a retrospective analysis of data for five years from four institutions comparing stone passage rates in children with ureteric stones ≤10mm, aged 2-18, treated with tamsulosin vs. analgesia alone. The study identified 449 children, of whom 334 were...

Fluoroquinolone resistant rectal colonisation predicts risk of infectious complications after TRPB

Transrectal prostate biopsy (TRPB) has been associated with increased risk of infection between 3.6-5% and sepsis rates of 0.3-3.1% mainly due to fluoroquinolone resistance (FQR). At present, FQ antibiotic prophylaxis is utilised commonly across North America and Europe but due...

Patients’ preferences for additional (cytoreductive) treatments to the prostate and metastasis in metastatic prostate cancer

Patients diagnosed with metastatic prostate cancer at first diagnosis or de novo synchronous metastatic hormone-sensitive prostate cancer (mHSPC) have had reported increases in overall survival due to rapid advances and intensification of systemic therapy regimes beyond traditional androgen deprivation therapy...