Utility of Multiparametric Prostate MRI to Predict Regional or Distant Metastatic Disease Against Conventional Staging Using CT and Bone Scintigraphy or 68Ga-PSMA PET in Intermediate-to-High-Risk Prostate Cancer.

Background: Multiparametric magnetic resonance imaging (mpMRI) is now the standard of care to guide prostate biopsies during workups and assessment of men with suspected prostate cancer (PCa). In addition to intraprostatic lesion detection, MRI usually covers the bony pelvis and pelvic lymph nodes, two of the commonest sites for metastatic disease. Subsequent staging has traditionally been based on further scanning using a combination of computed tomography (CT) and bone scintigraphy (BS), and more recently, positron emission tomography (PET) scanning with prostate-specific membrane antigen (PSMA) ligand.

Penile dermatology for the general practitioner: A pragmatic approach to diagnosis and management.

Background: Genital skin conditions are rare and pose a diagnostic challenge due to their diverse pathology. Patient anxiety and referral decisions add complexity for primary caregivers. Demographics and overlapping symptoms complicate diagnosis, causing anxiety for both patients and clinicians.

Updates in digital shared care: Launching into the 21st century.

Background: The recent Intergenerational Report (2023) highlighted that the Australian healthcare system will face increasing economic and logistical challenges, with projected growth in health spending due to an ageing population and an increasing number of chronic diseases. Shared care, a model emphasising collaboration between nursing and allied health, general practice and specialist care providers, has emerged as one solution.

Objective: This paper explores the contemporary shared care landscape in Australia, highlighting the digital transformation of healthcare, the adoption of eHealth technologies, and their impact on improving patient care coordination.

IMRA/SRS Delphi consensus on international standards for common core components of robotic surgical training design.

Robotic surgery has expanded internationally at pace. There are multiple local robotic training pathways but there is inconsistency in standardisation of core common components for curricula internationally. A framework is required to define key objectives that can be implemented across robotic training ecosystems.

eHealth Platforms Facilitate Prostate Cancer Shared Care: A Systematic Review.

Background: Prostate cancer survivorship care is essential for the early identification of cancer recurrence and progression and the monitoring of adverse effects. Prostate cancer survivorship programs have enabled care to be shared between specialists using digital healthcare platforms. We systematically reviewed the literature to examine if prostate cancer survivorship care had been successfully digitalised.

Perspectives on technology: urethral slings in a post-mesh world.

Objectives: To detail the history of synthetic mid-urethral slings (SMUSs) and fascial slings, their efficacy, associated complications, and changes to practice that have occurred after the issuing of the 2011 US Food and Drug Administration (FDA) Safety Communication statement on transvaginal mesh (TVM), and to highlight the need for surgical registries and high-quality randomised controlled data to guide recommendations for continence procedures, in view of current concerns regarding mesh.

Methods: A literature search was conducted in EMBASE, PubMed, and the Cochrane Database of systematic reviews to identify articles published from 2011 onward, following the FDA Safety Communication regarding TVM.

Results: Prior to the formal FDA Safety Communication in 2011, TVM was considered a safe option for the treatment of both pelvic organ prolapse (POP) and stress urinary incontinence (SUI).

Evolution of hormonal therapy for prostate cancer.

Background: Prostate cancer (PCa) is the most common malignancy after skin cancer in men in Australia. Its management varies according to tumour stage. Due to the significant dependence on androgen receptor signalling, agents that interfere with this pathway (most commonly medical castration in the form of androgen deprivation therapy [ADT]) are the mainstay treatment of advanced disease.

Urological focus on gender affirmation surgery.

Background: Gender affirmation surgery plays an important role in the treatment of gender dysphoria. These procedures play a vital role in aligning individuals' physical characteristics with their gender identity, resulting in improved mental health and overall wellbeing.

Objective: This article provides an overview of genital gender affirmation surgeries, focusing on the available options and appropriate referral criteria for general practitioners and surgeons.

Minimally invasive interventions for lower urinary tract symptoms: What sits between medical therapy and transurethral resection of the prostate.

Background: There are a variety of medical and surgical treatment options available today for the management of lower urinary tract symptoms (LUTS) secondary to bladder outlet obstruction due to benign prostatic hyperplasia (BPH).

Objective: The aim of this paper is to highlight the various treatment options available for the management of bladder outlet obstruction secondary to BPH and discuss the benefits and potential drawbacks of each.

Discussion: Lifestyle and dietary modification and medical therapies, such as an alpha-1 blocker as monotherapy, should be considered as first-line when initially counselling a patient for LUTS secondary to bladder outlet obstruction due to BPH.

When less is more: Updates in active surveillance and watchful waiting in the management of prostate cancer.

Background: Prostate cancer is the second most common cancer among men globally. A range of management options are available for prostate cancer, including surgery, radiation therapy, hormone therapy, chemotherapy, or surveillance. Conservative strategies include active surveillance and watchful waiting, which differ in their intent.

The treatment landscape of nonmetastatic castrate resistant prostate cancer: A contemporary perspective.

Objectives: The incidence of nonmetastatic castrate resistant prostate cancer (nmCRPC) is not well defined in contemporary practice. The aim of this study is to describe the incidence and patterns of treatment of nmCRPC over the last 6 years at a single high-volume Australian health institution.

Subjects And Methods: All men newly diagnosed with prostate cancer at Western Health, Melbourne from January 2016 to December 2021 were included in the study.