False Positive Multiparametric Magnetic Resonance Imaging Phenotypes in the Biopsy-naïve Prostate: Are They Distinct from Significant Cancer-associated Lesions? Lessons from PROMIS.

Background: False positive multiparametric magnetic resonance imaging (mpMRI) phenotypes prompt unnecessary biopsies. The Prostate MRI Imaging Study (PROMIS) provides a unique opportunity to explore such phenotypes in biopsy-naïve men with raised prostate-specific antigen (PSA) and suspected cancer.

Objective: To compare mpMRI lesions in men with/without significant cancer on transperineal mapping biopsy (TPM).

What Type of Prostate Cancer Is Systematically Overlooked by Multiparametric Magnetic Resonance Imaging? An Analysis from the PROMIS Cohort.

Background: All risk stratification strategies in cancer overlook a spectrum of disease. The Prostate MR Imaging Study (PROMIS) provides a unique opportunity to explore cancers that are overlooked by multiparametric magnetic resonance imaging (mpMRI).

Objective: To summarise attributes of cancers that are systematically overlooked by mpMRI.

Safety and efficacy of Holmium laser enucleation of the prostate (HoLEP) in patients with previous transperineal biopsy (TPB): outcomes from a dual-centre case-control study.

Background: We investigated the surgical feasibility, safety and effectiveness of 50 W (low power) Holmium Laser enucleation of the prostate (HoLEP) in patients who have undergone previous template biopsy of the prostate (TPB).

Methods: Data encompassing pre-operative baseline characteristics, intra-operative measures and post-operative outcomes was collected for 109 patients undergoing HoLEP across two UK centres. Patients were stratified into two groups; group 1 (n = 24) had undergone previous TPB were compared with 'controls' (no previous TPB) in group 2 (n = 85).

Outcomes and Long-term Follow-up of Patients with Cystine Stones: a Systematic Review.

Purpose Of Review: Cystine stone patients can be difficult to manage with frequent recurrences. We performed a systematic review with a view to assessing interventions, compliance and their long-term outcomes.

Recent Findings: Ten retrospective observational studies (253 patients) assessed the outcomes and long-term follow-up of cystine stone patients.

Prolonged and Increased Usage of a Flexible Ureterorenoscope: The Maelor FURS Protocol.

We present our point of technique detailing the specific preoperative and postoperative steps used in our institution to prolong the use of a flexible ureterorenoscope, and discuss the potential cost-effectiveness of this protocol. We have used a single flexible ureterorenoscope, for 145 consecutive cases to date, using the protocol described in this article. This prolonged use has resulted in a calculated cost per case of £273.

The Use of Cook Resonance Metallic Ureteral Stent in Cases of Obstructive Uropathy from Persistent Neoureteral Stenosis, Following Kidney Transplantation.

Following kidney transplantation, persistent cases of obstructive uropathy from neoureteral stenosis, at the reimplantation site, may require management with permanent, long-term Double-J stenting, following failed open surgical and minimally invasive procedures. We report our experience of the use of Cook Resonance metallic ureteral stent to manage such cases endourologically. Medium-term follow-up of two cases requiring long-term ureteral stenting.

Urolift - minimally invasive surgical BPH management.

An ideal treatment option for symptomatic Benign Prostatic Hyperplasia (BPH) should relieve lower urinary tract symptoms (LUTS) and restore Quality of Life (QoL). Currently available medical therapies and surgical options for symptomatic BPH have side effects that adversely affects quality of life. Prostatic urethral lift (PUL) is a novel endourology procedure that promises to relieve LUTS without the aforementioned side effects.

The role of transperineal template biopsies of the prostate in the diagnosis of prostate cancer: a review.

The incidence of prostate cancer has shown a significant increase, highlighting the importance of early diagnosis. Current practice considers histological diagnosis a necessity in the majority of the cases. The limitations of transrectal biopsies led to the development of the promising transperineal prostatic biopsies.

The first use of Resonance(®) metallic ureteric stent in a case of obstructed transplant kidney.

Introduction: To date, double JJ stent is the mainstay ureteric stent used in a transplant kidney. We herein report the first use of Resonance(®) metallic ureteric stent to manage ureteric obstruction in a transplant kidney.

Presentation Of Case: A 45-year-old lady underwent an uneventful living related donor renal transplantation.

Massive steinstrasse without lithotripsy: a rare case report.

The accumulation of ureteric stone fragments causing ureteric blockage is known as 'Steinstrasse' or 'Stone Street' and is usually described as a complication of shock-wave lithotripsy (SWL). We herein present a rare case of massive Steinstrasse in a young male patient with no previous history of urolithiasis or lithotripsy.

The 3-finger technique in establishing percutaneous renal access: a new and simple method for junior trainees.

Introduction And Objectives: Urology trainees may lack experience in gaining renal access during percutaneous nephrolithomy (PCNL). Establishing the correct depth of initial percutaneous needle insertion is one of the major obstacles. As such, we have identified an easy technique, which can be performed, to establish correct depth adjustment allowing easier access.

A new training model for adult circumcision.

Background: Adult circumcision is an extremely common surgical operation. As such, we developed a simple model to teach junior doctors the various techniques of circumcision in a safe, reliable, and realistic manner.

Materials And Methods: A commonly available simulated model penis (Pharmabotics, Limited, Winchester, United Kingdom) is used, which is then covered with a 30-mm diameter, 400-mm long, double-layered simulated bowel (Limbs & Things, Bristol, United Kingdom).

Incidental urinary tract pathologies in the one-stop prostate cancer clinic.

Objective: We determined the prevalence of incidental urinary tract pathologies in patients referred to the one-stop suspected prostate cancer clinic and assessed the evaluation and outcome of these pathologies.

Methods: One hundred and ninety patients were referred to the one-stop suspected prostate cancer clinic over a 6-month period. The records of patients with incidental urinary tract pathologies were retrospectively reviewed for demographic characteristics, mode of clinical presentation, further investigations performed, the final diagnosis and the treatment given.

A new model for suprapubic catheterization: the MediPlus Seldinger suprapubic catheter.

Insertion of a suprapubic catheter is one of the essential skills that all surgeons should master. It provides an alternative way to drain the bladder in cases where urethral catheterization is contraindicated or deemed difficult. It also has a role in elective cases where long-term drainage of the bladder is required.

Current status of robotic surgery in pediatric urology.

Robotic-assisted pediatric urological surgery has emerged as a valid and reliable surgical therapy, which maintains the advantages of the minimally invasive approach but avoids the restrictions of laparoscopic surgery. The ideal application of the robot in the Pediatric population is in procedures requiring delicate suturing such as pyeloplasty or partial nephrectomy although the use of robotic surgery has been reported in a wide range of other procedures, particularly the diverse reconstructive pediatric operations. In this article, we review the current indications and results of robotics in the management of pediatric pathology.

A training model for suprapubic catheter insertion: the UroEmerge suprapubic catheter model.

Suprapubic catheter insertion is a fundamental practical skill that all clinicians should be familiar with, yet there are great practical difficulties in training in this area. A training model was designed to facilitate teaching, and then this model was subsequently tested in an emergency urology practical skills course.

Long-term follow-up after retroperitoneal laparoscopic decortication of symptomatic renal cysts.

Introduction: The purpose of this study was to present our long-term experience of retroperitoneal laparoscopic decortication (RLD) for patients with severely symptomatic simple renal cysts. The feasibility, safety and efficacy of this technique is reported, along with immediate and long-term clinical outcomes.

Materials And Methods: Over a 6-year period, 22 consecutive patients with symptomatic simple renal cysts underwent RLD by a single surgeon.

Giant nonfunctioning carcinoma of the adrenal cortex mimicking renal cell carcinoma: a diagnostic dilemma.

Adrenocortical carcinoma is a rare, highly malignant neoplasm that originates in the adrenal cortex and is difficult to differentiate from renal cell carcinoma, especially if it is gigantic and nonfunctional. We report the case of a 40-year-old man with an incidental mass in the right upper abdomen. Magnetic resonance imaging revealed that the mass originated from the right kidney and was highly suggestive of renal cell carcinoma.

ProstaScint and its role in the diagnosis of prostate cancer.

Cancer of the prostate is the most common cancer in males accounting for 33% of newly diagnosed cases. It is the second leading cause of cancer death in American males. The prevalence of prostate cancer increases most rapidly with age and the incidence (unlike other cancers) continues to rise with advancing age.

Percutaneous needle biopsy for indeterminate renal masses: a national survey of UK consultant urologists.

Background: The use of percutaneous needle biopsy in the evaluation of indeterminate renal masses is controversial and its role in management remains largely unclear. We set to establish current practice on this issue in UK urology departments.

Methods: We conducted a national questionnaire survey of all consultant urologists in the UK, to establish current practice and attitudes towards percutaneous needle biopsy in the management of indeterminate renal masses.

The artificial urinary sphincter.

Urinary incontinence (UI) is regarded as a major health issue affecting a large sector of the population. The International Continence Society defines UI as the complaint of involuntary leakage of urine that is objectively demonstrated and is a social and hygienic problem. It is caused by a wide range of factors and it has a great negative impact on the lifestyle of patients, as well as a burden on the healthcare system, since it affects an estimated 10 million patients in the USA.