T. Nambirajan

Artificial urinary sphincter implantation in the irradiated patient: safety, efficacy and satisfaction

Objective To compare the long‐term outcome of artificial urinary sphincter (AUS) implantation in patients after prostatectomy, with and with no history of previous irradiation.

Cadaveric fascia lata pubovaginal slings: early results on safety, efficacy and patient satisfaction

Objective  To prospectively evaluate and quantify the efficacy of cadaveric fascia lata (CFL) as an allograft material in pubovaginal sling placement to treat stress urinary incontinence (SUI).

Virtual cystoscopy from computed tomography: a pilot study

To assess the feasibility of virtual cystoscopy reconstructed from helical computed tomography (CT) obtained using an intravenous contrast agent, and to correlate the findings with flexible (FC) and rigid cystoscopy (RC) in patients with bladder tumours.

The utility of prostate-specific antigen velocity thresholds in clinical practice:a population-based analysis

To investigate the ability of prostate‐specific antigen velocity (PSAV) to predict prostate cancer, and assess the test characteristics of several PSAV thresholds for identifying prostate cancer and high‐grade cancers.

Urethral stents for detrusor sphincter dyssynergia

failure to fully eliminate residual urine, the potential for significant haemorrhage and the need to repeat the procedure in up to 25% of patients [2]. Patients are also reliant upon condom-catheter drainage and less than half of patients continue with this drainage method in the long term. An alternative, less-invasive method is sphincter ablation by direct injection of Botulinum toxin. This provides only temporary relief, and repeat injections are necessary every couple of months. Balloon dilatation is another alternative, but this is restricted by recurrent obstruction and excessive bleeding [3].

Repeating an abnormal prostate-specific antigen (PSA) level: how relevant is a decrease in PSA?

To examine the practice of repeating an abnormal prostate-specific antigen (PSA) level before proceeding to prostate biopsy, we assessed the pattern of PSA change following an initially raised (⩾4.0 ng ml−1) PSA, and the relationship of this to prostate cancer diagnosis. In 7052 men, 71.2% with initially raised PSA had a reduction in PSA, with values <4.0 ng ml−1 in 37.8%. A total of 43.0% of men with prostate cancer showed a PSA decrease below their baseline level. Short-term decreases in PSA may occur in men with prostate cancer, including high-grade cancer, and so should not influence the decision to proceed to prostate biopsy.

Intra‐testicular varicocele presenting as acute scrotum

The term varicocele describes a dilated, tortuous and elongated pampiniform plexus of veins, which is well known in relation to the spermatic cord. Recently varicocele has also been observed inside the testis, and this new entity is known as intra‐testicular varicocele. We present a case of intra‐testicular varicocele presenting as acute scrotum and discuss the management issues.

Squamous cell carcinoma and transitional cell carcinoma arising in bladder augmentations.

Tumours arising in bowel-augmented bladders are rare. Usually these tumours are adenocarcinomas that occur along the anastomotic line. We present two unusual tumours, squamous cell carcinoma and transitional cell carcinoma, that occurred in bladder augmentations. We also emphasize the need for regular cystoscopic surveillance.

The incidence and outcome of abnormal prostatic specific antigen in patients referred to a LUTS clinic

ConclusionsApproximately one in three patients being referred to a LUTS clinic have a raised PSA level. The incidence of prostate cancer in asymptomatic males under 70 years has been reported at 3.3%. Our data suggest that the incidence of prostate cancer in such patients is higher if they have LUTS. This may have significant implications for screening programmes and further studies are needed to clarify this issue.

Prospective, randomised, placebo-controlled trial of peri-prostatic local anaesthetic in transrectal prostate biopsy

ConclusionPeri-prostatic local anaesthetic with 1% lignocaine reduces discomfort significantly during TRUS biopsy and we recommend it should be used routinely.