Incidence, Predictive Factors and Preventive Measures for Inguinal Hernia following Robotic and Laparoscopic Radical Prostatectomy: A Systematic Review.

Purpose: Inguinal hernia is a known sequel of radical prostatectomy which contributes to patient morbidity and health care expenditure. In this systematic review we evaluated the incidence of inguinal hernia associated with minimally invasive radical prostatectomy, in addition to predictive factors and preventive measures.

Materials And Methods: We searched PubMed® and Embase® between 2000 and February 2018 using the search terms inguinal hernia and radical prostatectomy.

Semi-Automatic Electronic Stent Register: a novel approach to preventing ureteric stents lost to follow up.

Background: Ureteric stents are indispensable tools in modern urology; however, the risk of them not being followed-up once inserted poses medical and medico-legal risks. Stent registers are a common solution to mitigate this risk; however, manual registers are logistically challenging, especially for busy units.

Methods: Western Sydney Local Health District developed a novel Semi-Automatic Electronic Stent Register (SAESR) utilizing billing information to track stent insertions.

A Case of Metastatic Melanoma in the Ureter.

Advances in the treatment of melanoma are resulting in patients living for extended periods after being diagnosed with metastatic disease. Metastases to the ureter are rare, but they have been described in the literature on a number of occasions. In this case report, we describe a patient with established metastatic melanoma who, whilst taking and responding to immunomodulatory therapy, was found to have an obstructive mass in the middle of his left ureter.

Benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH), which causes lower urinary tract symptoms (LUTS), is a common diagnosis among the ageing male population with increasing prevalence. Many risks factors, both modifiable and non-modifiable, can increase the risk of development and progression of BPH and LUTS. The symptoms can be obstructive (resulting in urinary hesitancy, weak stream, straining or prolonged voiding) or irritative (resulting in increased urinary frequency and urgency, nocturia, urge incontinence and reduced voiding volumes), or can affect the patient after micturition (for example, postvoid dribble or incomplete emptying).

Men under the age of 55 years with screen detected prostate cancer do not have less significant disease compared to older men in a population of patients in Australia.

Background: The American Urological Association (AUA) changed their Prostate-Specific Antigen (PSA) screening guidelines in 2013 to not recommend testing in men under 55 years of age without significant risk factors (such as a family history of prostate cancer or African ethnicity). The AUA argues that the rates of 'insignificant' prostate cancer (PC) in men under 55 are so high that the potential harms of PSA-testing in this population (over diagnosis and overtreatment) outweigh the benefits (early detection and treatment). Our study aims to identify and compare the rates of insignificant and high-risk PC in men diagnosed with PC ≤55 years and >55 years in two centres in Sydney, Australia.

Validation of a patient reported outcome questionnaire for assessing success of endoscopic prostatectomy.

Purpose: Several international committees involved in establishing standards of care have recommended that patients undergoing surgery for bladder outlet obstruction should be assessed with patient reported outcomes (PRO). The Patient Global Impression of Improvement (PGI-I) is an instrument designed to measure a patients interpretation of symptom changes following intervention. The objective of this study was to validate the PGI-I as a PRO assessment following surgery for bladder outflow obstruction (BOO) in men with benign prostatic hyperplasia (BPH).

A cost-effective, easily reproducible, suprapubic catheter insertion simulation training model.

Introduction: Suprapubic catheter (SPC) insertion is a basic skill required of surgical trainees. It is likely a trainee's first attempt at the procedure, will be undertaken without direct supervision at night and without access to aids of catheterization. Unfortunately, lack of simulation models and unpredictability of when SPCs are required, make it difficult to acquire this skill.

Location and pathological characteristics of cancers in radical prostatectomy specimens identified by transperineal biopsy compared to transrectal biopsy.

Purpose: Anterior tumors are estimated to constitute 20% of prostate cancers. Current data indicate that transperineal biopsy is more reliable than transrectal biopsy in identifying these tumors. If correct, this superior reliability should result in an increased proportion of anterior tumors identified by transperineal biopsy.

Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer.

Context: There are different treatment options for localized prostate cancer. The success of high-intensity focused ultrasound (HIFU) is based largely on biochemical prostate specific antigen (PSA) results.

Aims: To evaluate the impact of using a low PSA threshold to perform prostate biopsies after HIFU in order to more accurately gauge treatment success.

Accuracy of primary systematic template guided transperineal biopsy of the prostate for locating prostate cancer: a comparison with radical prostatectomy specimens.

Purpose: We determined whether systematic template guided transperineal biopsies can accurately locate and sensitively detect prostate cancer. In addition, we reported discrepancies between diagnostic and pathological Gleason scores, and investigated whether prostate size had an effect on the cancer detection rate.

Materials And Methods: This retrospective diagnostic accuracy study compares the results of primary transperineal biopsies with the radical prostatectomy pathology of 414 consecutive patients treated at a single institution between November 2002 and August 2010.

Sexual function outcome following photoselective vaporisation of the prostate.

Introduction: There is little reported on sexual functional outcome following photoselective vaporisation of the prostate using the 120 W lithium triborate laser.

Objective: The objective of this study was to evaluate changes in sexual function at 3 and 12 months following PVP.

Material And Methods: The primary outcome measures were changes in voiding parameters and changes in erectile function in the international index of erectile function (IIEF-5).

Photoselective vaporization of the prostate in men taking clopidogrel.

Aim: To evaluate the peri-operative morbidity of men taking clopidogrel who underwent photoselective vaporisation of the prostate (PVP).

Patients And Methods: A prospective database was collected. Between March 2005 and July 2010, 480 men underwent PVP.

Acceptance of repeat transrectal ultrasonography guided prostate biopsies with local anaesthesia.

Objective: • To measure patient discomfort associated with transrectal ultrasonography guided prostate biopsy (TRUSPB) performed with periprostatic local anaesthetic (LA) infiltration and to document agreement to possible repeat biopsy, as a recent audit showed that 86% of Australian urologists performed prostate biopsies using sedation or general anaesthesia (GA), which implies many urologists think patients are unwilling to tolerate the procedure under LA block and/or may refuse a repeat procedure.

Patients And Methods: • This was a prospective cohort study following all men undergoing TRUSPB in 2008. • Immediately after the procedure the men were asked to complete a visual analogue pain score.

Long-term results of bipolar radiofrequency needle ablation of the prostate for lower urinary tract symptoms.

Purpose: To report the first long-term experience on the efficacy of bipolar transurethral radiofrequency needle ablation (RFA) in patients with lower urinary tract symptoms that are secondary to benign prostatic hyperplasia.

Patients And Methods: A nonrandomized prospective cohort of 12 candidates for transurethral resection of the prostate underwent bipolar transurethral RFA in 2004 (mean age 63; prostate volume 34 cc). Patients were evaluated preoperatively and at 3, 12, 36, and 60 months postprocedure.

Photoselective vaporization of the prostate with the 120-W lithium triborate laser in men taking coumadin.

Objective: To specifically evaluate perioperative morbidity associated with men who were taking coumadin and continued on this medication at therapeutic levels for the purposes of the prostate (PVP). Increasing numbers of men are taking coumadin for medical comorbidity and this creates clinical concerns for urologists treating such men with benign prostatic obstruction. Photoselective vaporization of the PVP has been shown to be an effective treatment for men receiving anticoagulation treatment, although previously published studies have evaluated a mix of men on aspirin, coumadin, or clopidogrel.

Photoselective vaporization for prostatic obstruction with the 120-W lithium triborate laser: 1-year clinical outcomes.

There are few reports of the clinical outcomes of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) using the 120-W lithium triborate (LBO) laser. The present study evaluates clinical outcomes of 76 men treated with the 120-W LBO laser by an experienced PVP surgeon with 12 months follow up. The International Prostate Symptom Score (IPSS), peak flow rate (Qmax) and post-void residual (PVR) were examined at baseline and at 3 and 12 months.