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History of prostate biopsy – part 2

For Part 1 of this topic is available here. The major limitations of the transrectal ultrasound (TRUS) guided prostate biopsy (PBx) protocols are the risk of profound sepsis and the risk of persistently significant false negative rates, related to the...

Vitamin D and LUTS

Lower urinary tract symptoms (LUTS) and vitamin D deficiency have been thought to be connected, but the association has been inconsistent. Vitamin D receptors have been identified in the bladder, prostate and pelvic floor muscles, and it has been linked...

LUTS among Caucasian-European men who have sex with men: findings from a real-life survey

This study is the first of its kind to report an association between men who have sex with men (MSM) and lower urinary tract symptoms (LUTS). Nine hundred and forty-nine consecutive individuals who presented to a uro-andrology clinic for complaints...

A guide to local anaesthetic transperineal prostate biopsy

In the UK, nearly 100,000 men undergo a prostate biopsy annually, a figure projected to double in the next decade [1]. In recent years, we have observed a paradigm shift in urological practice in numerous UK hospitals. The conventional transrectal,...

The role of transperineal template biopsies in the diagnosis of prostate cancer

The case In 2002, Mr A, a 64-year-old software engineer, was referred by his GP for further investigation of a raised prostate specific antigen (PSA) of 6.2. His prostate felt benign. He underwent transrectal ultrasound guided (TRUS) prostate biopsies. This...

Infections and inflammation: Part 1

See also Part 2 and Part 3. Case 1 A 59-year-old man presented with right loin pain. His GP arranged for him to have an intravenous urogram (IVU) and subsequent CT urogram performed. What is the likely diagnosis? What are...

Is Retzius-sparing prostatectomy the way forward?

Urinary incontinence is a common complication of conventional robot-assisted radical prostatectomy (RARP). Retzius-sparing RARP is performed through the pouch of Douglas to avoid destroying the pelvic fascia and the prostate’s anatomical structures. It has shown early favourable results in terms...

Evaluation of the learning curve for learning MRI-US fusion prostate biopsies

With the advent of one-stop prostate cancer diagnostic clinics, the findings of this study are of interest to readers who may be implementing MRI-US transrectal or transperineal fusion biopsies to their clinical practice. This prospective cohort study evaluated 779 consecutive...

Morbidity and mortality after surgery for LUTS

The market for bladder outflow obstruction surgery is currently wide open with new technologies such as Urolift® emerging. One of the key selling points of new technologies is the comparative safety and efficacy compared to traditional techniques such as transurethral...

The role of PET-CT imaging in prostate cancer

Prostate cancer (PCa) is the second most common cancer in the UK, with 43,000 cases in 2017-18 [1,2]. Accurate primary staging and the detection of suspected recurrence following treatment is vital for directing management and predicting prognosis. This has conventionally...

HOLEP and detrusor underactivity

Lower urinary tract symptoms (LUTS) are common among adult males, significantly influence quality of life (QoL) and contribute to pressure on the NHS. LUTS are conventionally associated with benign prostatic obstruction (BPO), which is commonly observed during the histological progression...

Effect of DUA on surgical outcomes of HoLEP

Lower urinary tract symptoms (LUTS) become increasingly common in men as they age, with over 70–90% of men aged over 80 experiencing these issues. Detrusor underactivity (DUA) is characterised by a weakened bladder contraction, leading to prolonged or incomplete bladder...