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A retrospective review conducted in our urology unit to assess the efficiency for requesting bone scans for newly diagnosed prostate cancer patients, aiming to minimize radiation exposure and avoiding unnecessary investigations as cost effective measure.A retrospective observational study included 360 patients with newly diagnosed prostate cancer within urology department at Calderdale and Huddersfield NHS Trust from April 2016 to March 2018. Parameters observed were: the prostatic specific antigen (PSA) on diagnosis, Gleason score, staging magnetic resonance imaging, and bone scans. We analyzed the possible correlation of the Gleason score and PSA to determine the risk of bony metastasis. Regarding PSA: Patients were categorized as with PSA 15, PSA ≥15. Regarding Gleason score: Patients were categorized as patients with grade group 1 or 2 and patients with grade group 3 and above. Data recorded was then analyzed using χA total of 360 patients: 91 patients (25%) had positive bony metastasis. While 269 patients (75%) had a clear bone scan. Among patients with grade group 3 or above or having PSA ≥15, 90 patients out of 324 patients had bony metastasis (38%). Among patients with grade group 1 or 2 and PSA 15, only 1 patient out of 36 had bony metastasis (2.7%). Negative predictive value of grade group 1 or 2 and PSA 15 for bony metastasis was 97.22%.Using a cutoff level of PSA 15 in grade group 1 and 2 seems to be a safe and efficient tool to exclude newly diagnosed prostate cancer patients from having an isotope bone scan for staging purpose.

Background: Phosphodiesterase enzyme inhibitors (PDEIs) are most commonly prescribed by urologists for the treatment of erectile dysfunction. They are also gaining popularity as a treatment for lower urinary tract symptoms, based on their effect on smooth muscles – either vascular smooth muscles or smooth muscles in the urinary tract. For vascular smooth muscles, they cause vasodilation, enhanced microcirculatory haemodynamics through inhibition of platelet aggregation and adhesion, induction of apoptosis of adhesion fibroblasts and a reduction in the scarring process. Methodology: We reviewed articles published in English and indexed in the PubMed, Embase and Google Scholar databases, and consulted textbooks. Key search terms used were: urethral stricture, anti-fibrotic, scar-modulating agent, PDEIs, urethral scarring and urethroplasty. We created a synopsis of relevant articles, including original research studies and reviews. Level of evidence: Not applicable.

Peyronie’s disease affects elastic fibers located within the tunica albuginea of the penis...

Sedentary behavior is one of the major risk factors for cardiovascular mortality; hence there is a need to promote physical activity (PA) among adults aged 60–86 years. The aim of this narrative review was to evaluate the role of PA in the prevention and treatment of chronic diseases among older adults. Relevant studies (original articles, systematic reviews, and meta-analyses) that reported on the effects of PA in older adults from 1998 to 2019 were selected. The following electronic databases were searched: PubMed, ScienceDirect, PsycINFO, Embase, Medline, Sports Discus, Web of Science, and Cochrane database. Physical exercise at different intensities was shown to be effective in the prevention and treatment of overweight, functional decline, and mood disorders in older adults. Moderate-to-high intensity endurance exercise can be effective in the prevention of diabetes type 2, hypertension, and cancer in older adults. Resistance training at different intensities was shown to be effective in the prevention and treatment of obesity in the elderly. Mobility and balance training were effective in preventing falls in older individuals. Combined exercise training regimen comprising moderate-to-vigorous intensity aerobic and resistance exercise is beneficial in the prevention of disability, osteoporosis, hypertension, and falls among older adults. Moreover, combined exercise training improves immune function and antioxidant capacity in older adults. Based on the studies reviewed, PA was found to be an effective tool for the prevention and treatment of chronic diseases among older adults.