The Sensitivity and Specificity of Multiparametric Magnetic Resonance Imaging and Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Predicting Seminal Vesicle Invasion in Clinically Significant Prostate Cancer: A Multicenter Retrospective Study.

The presence of seminal vesicle invasion (SVI) in prostate cancer (PCa) is associated with poorer postoperative outcomes. This study evaluates the predictive value of magnetic resonance imaging (MRI) and prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) for SVI in PCa. This cohort study included consecutive robotic prostatectomy patients for PCa at three Australian tertiary referral centres between April 2016 and September 2022.

Rippling life on a dormant planet: hibernation of ribosomes, RNA polymerases, and other essential enzymes.

Throughout the tree of life, cells and organisms enter states of dormancy or hibernation as a key feature of their biology: from a bacterium arresting its growth in response to starvation, to a plant seed anticipating placement in fertile ground, to a human oocyte poised for fertilization to create a new life. Recent research shows that when cells hibernate, many of their essential enzymes hibernate too: they disengage from their substrates and associate with a specialized group of proteins known as hibernation factors. Here, we summarize how hibernation factors protect essential cellular enzymes from undesired activity or irreparable damage in hibernating cells.

Comparison of diagnostic accuracy of ultra low-dose computed tomography and X-ray of the kidneys, ureters and bladder for urolithiasis in the follow-up setting.

Introduction: Urolithiasis is frequently followed up with a low-dose computed tomography of the kidneys ureters and bladder (LD-CTKUB) with doses typically less than 3 millisieverts. Although X-ray is a lower dose (0.5-1.

Improved early and late continence following robot-assisted radical prostatectomy with concurrent bladder neck fascial sling (RoboSling).

Objective: To describe a novel RoboSling technique performed at the time of robot-assisted radical prostatectomy (RARP) and its utility for enhancing urinary function recovery postoperatively.

Materials And Methods: The surgical technique involves harvesting a vascularised, fascial flap from the peritoneum on the posterior aspect of the bladder. Following completion of prostatectomy, the autologous flap is tunnelled underneath the bladder and incorporated into the rectourethralis and vertical longitudinal detrusor fibres at the posterior bladder neck with a modified Rocco suture.

Ribosomal proteins can hold a more accurate record of bacterial thermal adaptation compared to rRNA.

Ribosomal genes are widely used as 'molecular clocks' to infer evolutionary relationships between species. However, their utility as 'molecular thermometers' for estimating optimal growth temperature of microorganisms remains uncertain. Previously, some estimations were made using the nucleotide composition of ribosomal RNA (rRNA), but the universal application of this approach was hindered by numerous outliers.

Lower Urinary Tract Functional Assessment of Men Undergoing Radical Prostatectomy: Correlation of Preoperative Clinical and Urodynamic Parameters.

Purpose: To assess baseline clinical and urodynamic profiles of a contemporary cohort of men undergoing radical prostatectomy (RP) as part of the ROSE (Robotic and Open Surgery for Prostate Cancer: A Prospective, Multi-centre, Comparative Study of Functional and Oncological Outcomes) study.

Methods: Men with localized prostate cancer undergoing RP were prospectively recruited to undergo clinical assessment and urodynamic testing prior to surgery as part of a clinical trial. The International Prostate Symptoms Score (IPSS) was used to determine participants' degree of lower urinary tract symptoms (LUTS).

Is a 10-minute surgical scrub necessary in urologic prosthetic surgery? A randomized study of the effect of a 5- vs 10-minute surgical scrub on bacterial colony counts in the genital skin.

Aims: To determine the antiseptic efficacy on bacterial colony counts of a 5- vs 10-minute surgical site scrub in urologic surgery.

Methods: A prospective cohort study was conducted in 101 patients presenting for elective urological procedures. Patients were randomized to a 5- or 10-minute groin scrub with Betadine (povidone-iodine).

The measurement of membranous urethral length using transperineal ultrasound prior to radical prostatectomy.

Objective: To compare preoperative membranous urethral length (MUL) measurements using magnetic resonance imaging (MRI) with two-dimensional transperineal ultrasound imaging (TPUS) in two supine positions on two separate days in men prior to radical prostatectomy.

Materials And Methods: MUL was prospectively measured in 18 male volunteers using MRI and on two separate occasions in two different patient positions using TPUS; the patient supine with the knees extended (Supine) and supine with the knees flexed to 70 degrees (Supine KF). Agreement between TPUS and MRI measurements of MUL was assessed using Bland-Altman method comparison techniques and a two-way mixed-effects single measures intraclass correlation (ICC).

Special considerations in the urological management of the older spinal cord injury patient.

Purpose: This paper reports the key findings of Committee 8 of the Joint SIU-ICUD Consultation on Urologic Management of the Spinal Cord Injured Patient and address issues pertaining to the older person with a SCI and the time-related changes relevant to their urological, gastrointestinal and functional management.

Methods: A literature review using the Pubmed and Ovid search engines was performed examining pertinent literature regarding SCI in the older patient.

Results: There is a rising incidence of both traumatic and non-traumatic spinal cord injury (SCI) in older people and improvements in healthcare and nutrition mean patients with SCI are living longer.

Pelvic floor ultrasound in the diagnosis of sling complications.

Purpose: The mid-urethral synthetic sling (MUS) procedure has become the standard of care for treatment of female stress urinary incontinence. However, a small number of patients will have complications following MUS including failure, obstructive voiding, sling erosion, or chronic pain. This paper discusses the role of 2D and 3D ultrasound imaging in the evaluation of the female patient with complications following placement of a synthetic mid-urethral sling.

Position statement: a clinical approach to the management of adult non-neurogenic overactive bladder.

Overactive bladder (OAB) is a highly prevalent medical condition that has an adverse impact on various health-related quality-of-life domains, including a significant psychosocial and financial burden. This position statement, formulated by members of the Urological Society of Australia and New Zealand and the UroGynaecological Society of Australasia, summarises the current recommendations for clinical diagnosis and treatment strategies in patients with non-neurogenic OAB, and guides clinicians in the decision-making process for managing the condition using evidence-based medicine. Main recommendations: Diagnosis and initial management should be based on thorough clinical history, examination and basic investigations to exclude underlying treatable causes such as urinary tract infection and urological malignancy.

Natural history of post-void residual urine volume over 5 years in community-dwelling older men: The Concord Health and Ageing in Men Project.

Aims: To describe the natural history of post-void residual urine volume (PVR) in community-dwelling older men.

Methods: The Concord Health and Ageing in Men Project involves a representative sample of community-dwelling men aged 70 and older in a defined geographic area of Sydney, Australia. PVR were measured at baseline and 2-year and 5-year follow-up.

Systematic review and meta-analysis of the diagnostic accuracy of low-dose computed tomography of the kidneys, ureters and bladder for urolithiasis.

Renal colic is a common clinical condition which is often investigated with a CT of the kidneys, ureters and bladder (CTKUB). Recent technological improvements have allowed a reduction in dose with the emergence of low-dose CTKUB (LD-CTKUB) techniques. The present meta-analysis aims to determine the diagnostic accuracy of LD-CTKUB in the diagnosis of clinically significant uroliths.

Lower Urinary Tract Symptoms and Incident Falls in Community Dwelling Older Men: The Concord Health and Ageing in Men Project.

Purpose: We sought to determine which lower urinary tract symptoms are associated with incident falls in community dwelling older men.

Materials And Methods: The Concord Health and Ageing in Men Project involves a representative sample of community dwelling men 70 years old or older in a defined geographic region in Sydney, New South Wales, Australia. Included in analysis were 1,090 men without neurological diseases, poor mobility or dementia at baseline.

Impact of dual energy characterization of urinary calculus on management.

Introduction: Dual energy CT (DECT) is a recent technique that is increasingly being used to differentiate between calcium and uric acid urinary tract calculi. The aim of this study is to determine if urinary calculi composition analysis determined by DECT scanning results in a change of patient management.

Method: All patients presenting with symptoms of renal colic, who had not previously undergone DECT scanning underwent DECT KUB.

Mid-term outcomes of a male retro-urethral, transobturator synthetic sling for treatment of post-prostatectomy incontinence: Impact of radiotherapy and storage dysfunction.

Purpose: To determine mid-term durability of the AdVance sling for post-prostatectomy incontinence (PPI) and impact of prior radiotherapy and storage dysfunction.

Method: Eighty men undergoing AdVance sling for PPI during 2008-2013 were reviewed. Pre-op urodynamics, pre and post-op pad usage, prior radiotherapy, and PGI-I scores were recorded.

Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms.

Background: Stress in doctors adversely affects decision-making, memory, information-recall and attention, thereby negatively impacting upon the provision of safe and high quality patient care. As such, stress in doctors has been subject to increasing scientific scrutiny and has amassed greater public awareness in recent years. The aims of this study are to describe stress levels and the psychological wellbeing of current junior medical officers (JMOs), and to compare this to their predecessors, American surgical residents and population norms.

A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men.

Background: Lower urinary tract symptoms (LUTS) have been associated with falls in studies either exclusively or predominantly of women. It is, therefore, less clear if LUTS are risk factors for falls in men.

Methods: We conducted a systematic review of the literature on the association between LUTS and falls, injuries, and fractures in community-dwelling older men.

Eight-Year Experience With Botulinum Toxin Type-A Injections for the Treatment of Nonneurogenic Overactive Bladder: Are Repeated Injections Worthwhile?

Purpose: To investigate the efficacy and safety of repeated botulinum toxin type-A (BTX-A) injections for patients with drug-refractory nonneurogenic overactive bladder (NNOAB) and explore factors predictive of outcome.

Methods: Data were collected from all patients receiving repeated BTX-A injections for drug-refractory NNOAB between 2004 and 2012. Trigone-sparing injections were administered under sedation with antibiotic prophylaxis.

Voiding dysfunction in older men.

Purpose Of Review: Voiding dysfunction in older men is an important health issue, with significant morbidity and biosocioeconomic burden. Treatment decisions are increasingly complex as many older men also suffer concurrent comorbidities and polypharmacy. A relatively sparse number of publications specifically examine this relevant topic.

Natural history of non-neurogenic overactive bladder and urinary incontinence over 5 years in community-dwelling older men: The concord health and aging in men project.

Aims: To describe the natural history of non-neurogenic overactive bladder (OAB) and urgency incontinence in community-dwelling older men.

Methods: A representative sample of 1,705 community-dwelling men aged 70 and older in a defined geographic area of Sydney, Australia, had their urinary symptoms assessed using the International Prostate Symptom Scores (IPSS) and the International Consultation of Incontinence Questionnaire (ICIQ) at baseline, 2-year follow-up, and 5-year follow-up. Four hundred and eighty-eight men without neurological diseases or prostate cancer during follow-up, or history of urological treatment at baseline were included in the analysis.

Botulinum toxin (OnabotulinumtoxinA) in the male non-neurogenic overactive bladder: clinical and quality of life outcomes.

Objective: To assess the efficacy of OnabotulinumtoxinA (BTXA) injections in men with drug-refractory non-neurogenic overactive bladder (NNOAB).

Patients And Methods: A total of 43 men received BTXA injections for NNOAB from 2004 to 2012. Patient Global Impression of Improvement (PGI-I) score was obtained.

Measuring anticholinergic drug exposure in older community-dwelling Australian men: a comparison of four different measures.

Aims: Anticholinergic drug exposure is associated with adverse outcomes in older people. While a number of tools have been developed to measure anticholinergic drug exposure, there is limited information about the agreement and overlap between the various scales. The aim of this study was to investigate the agreement and overlap between different measures of anticholinergic drug exposure in a cohort of community-dwelling older men.

Clinical outcome in male patients with detrusor overactivity with impaired contractility.

Purpose: To review the clinical outcomes of patients with voiding dysfunction who have detrusor overactivity with impaired contractility (DOIC) diagnosed with urodynamic studies.

Methods: Urodynamic reports from 2005 to 2009 were reviewed, and 54 male patients had findings consistent with DOIC. Patients with acontractile or neuropathic bladders were excluded.

Urodynamic testing: physiological background, setting-up, calibration and artefacts.

Urodynamics (UDS) is an interactive diagnostic study of lower urinary tract function. It is composed of several tests that can be used to obtain functional information about urine storage and expulsion. Its main goal is to reproduce the patients' symptoms and determine their cause.