Staring Into The Abyss
I was surprised at the referral in the first place, but baffled after seeing the patient in the flesh. It was someone else’s clinic, and the note read that this 94 year-old man on androgen deprivation for asymptomatic low volume metastatic prostate cancer for many years had a climbing PSA. About 8. Please discuss combined androgen blockade with him. I began the talk about how combined blockade has a pretty weak benefit at the best of times, and that in a 94 year-old it almost certainly would not…
Vasectomy causes aggressive prostate cancer – HELP!!!
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How many of you have already had a patient get in touch about this latest scare? As one expects nowadays, I first heard about this paper on Twitter within a few minutes of it being published, but it wasn't long after that a recent patient of mine rang my rooms to challenge me about the reassurance I had given him only last week about the lack of increased risk of prostate cancer, which he had specifically asked me about. And of course since then, we have had headlines in the mass media all over the…
#UroJC July 2014 – Is there a place for laser techniques in our current schema of bladder cancer diagnosis and management?
This month’s International Urology Journal Club (@iurojc) truly engaged a global audience with participants from ten countries including author Thomas Herrman (@trwhermann) from Hannover, Germany. A landmark 2000 followers was reached during July, nearly two years since @iurojc’s conception in late 2012. In fact, since this time nearly 1100 people have participated in the journal club from around the world.
Bladder cancer was up for debate for the first time this year and @iurojc trialled…
Canadian Urological Association 69th Annual Meeting on the Rock
June 27 to July 1, 2014 saw close to 900 Canadian urologists & associates come together in the country’s most easterly city – St John’s, Newfoundland – for the 69th annual Canadian Urological Association meeting (https://www.cua.org/). As ‘Newfies’ have a well-established reputation in our country for their extreme friendliness, unique traditions and ability to throw one hell of a party, it was a highly anticipated four days!
The meeting kicked off on Friday with various pre-CUA…
Editorial: Is zero sepsis alone enough to justify transperineal prostate biopsy?
The landscape of infectious complications after TRUS-guided biopsy of the prostate has changed dramatically. While sepsis after TRUS-guided prostate biopsy has always been a concern for urologists performing this very common procedure, in the past couple of years a number of factors have added to these pre-existing concerns for urologists and patients alike.
First, key papers have reported the true incidence of sepsis and hospital re-admission after TRUS biopsy and have shown that…
Consultant on call: incorporating lean thinking or Chaos theory?
The RCS report on ‘the implementation of the working time (EWTD) directive’ has recently been submitted. Recommendations include the need to rethink teams and services working patterns.
In urology a combination of the EWTD, depleted middle grade numbers and political will, have necessitated that consultants increasingly deliver out of hours service. There are theoretical advantages to a consultant being first point of call: the most experienced clinician physically present on the ‘shop floor’,…
Cystinuria Cookery Workshop
Cystinuria remains a challenge worldwide for urologists. Over the last 5 years we have introduced a multidisciplinary clinic for our cystinuria patients and as part of that, patients have an opportunity to see a dietician on every clinic visit.
This innovation has been well received by our patients with a focus on a diet with low intake of the cystine precursor methionine as well as a ‘healthy stone diet’ with low salt, high fluid etc. “But in practice, what does this mean I can eat?”…
Best bits of BAUS 2014
By Archie Fernando
As the friendliest taxi driver in the world dropped me off outside the vast BT centre in Liverpool he asked “if you’re all in there, what’s going to happen to the rest of us?” I wasn’t sure whether he was envisaging an epidemic of priapism, but I reckoned we’d be ok for a few days.
Inside the specious and well-designed conference centre (below) there was an overwhelmingly positive vibe as old friends caught up, new acquaintances were made and a packed scientific…
Editorial: Penile vibratory stimulation (PVS) a novel approach for penile rehabilitation post nerve sparing radical prostatectomy
The reported incidence of erectile dysfunction (ED) after nerve-sparing radical prostatectomy (NS-RP) varies in the literature from 30 to 80% [1]. This can be explained by the state of neuropraxia which affects the cavernosal nerves, even if the nerves are anatomically intact. During this period there is a lack of nocturnal tumescence which leads to tissue hypoxia and ischaemic damage to the cavernosal smooth muscles leading to smooth muscle necrosis and fibrosis, which in turn causes veno-occlusive…
Research vibrations
Here is a randomised trial from Denmark to uplift your mood this European summer. Penile vibratory stimulation may help with the recovery of erectile function after nerve-sparing radical prostatectomy [1]. However, it does not hasten recovery of continence. Building on the European theme, we were discussing alternative ways of influencing research communities and colleagues during the European Association of Urology (EAU) meeting in Stockholm. One obvious rising star is ResearchGate (Fig. 1).
ResearchGate…