In an article published in CMAJ, the authors report studying 404 boys under 3 years old. All these children presented to a large emergency department with symptoms suggestive of urinary tract infection and had a catheter urine specimen sent for microbiological studies. Only 393 cultures were available and the 11 boys without available results were excluded. The majority (90%) of the remaining 393 children were circumcised. 80 had proven urinary infection, of which 30% of uncircumcised boys had positive cultures compared to only 4.8% of circumcised boys. This was a significant difference with an odds ratio of 0.07. The authors concluded that the risk for urinary tract infection is higher in uncircumcised vs circumcised boys younger than 3 years. They went on to report that in uncircumcised boys 3 years and younger, the odds of having a urinary tract infection is not affected by the visibility of the meatus.
In a randomised controlled trial published in BJUI (2012), using 1000mg intramuscular testosterone Ho et al report that overall quality of life as well as symptoms of testosterone deficiency syndrome (TDS) were significantly improved at 48 weeks. All patients had a baseline serum testoserone of <12 and moderate or severe symptoms of TDS. The results were assessed using the AMS and SF-15 questionnaires. This good quality study adds to the growing body of evidence from the medical literature supporting the use of testosterone replacement therapy in patients with a low serum testosterone and symptoms of TDS. It did not investigate previously reported beneficial improvements in glucose intolerance and lipid profile.
In an article by Sieler et al published in BJUI (2012), histology from patients treated for prostate cancer with active surveilance (AS) were studied. AS was offered to patients with an estimated life expectancy of more than 10 years who fulfilled the following criteria, as described by Epstein et al : no Gleason pattern 4 or 5 at prostate biopsy, ≤2 positive biopsy cores, <50% tumour involvement of the biopsy cores and a PSA density <0.15 ng/mL/ccm. Patients were followed every 6 months with an annual rebiopsy until the age of 76. Disease reclassification to a higher risk was defined as either PSA progression (PSA doubling time ≤3 years) or biopsy progression (≥50% core involvement and/or ≥3 positive biopsy cores and/or Gleason pattern 4 or 5). Those patients fulfilling the initial criterion had a higher proportion of organ-confined cancers (89.7% vs 59.1%, P = 0.02) and fewer positive surgical margins (25.6% vs 40.9%) than others. The authors concluded that AS is safe, but encourage strict adherence to the Epstein criterion.
In an article by Korets et al published in BJUI (2012), the authors show that a delay of >60 days from prostate biopsy to radical surgery does not adversely affect outcome in patients with early prostate cancer. In the 1568 men studied, 1098 (70%), 303 (19.3%) and 167 (10.7%) had a delay of ≤60, 61–90 and >90 days, respectively, between biopsy and RP. A delay of >60 days was not associated with adverse pathological findings at surgery.he authors conclude that A delay of >60 days is not associated with adverse pathological outcomes in men with localized prostate cancer, nor does it correlate with worse biochemical cancer relapse-free survival.
The risk of being diagnosed with prostate cancer can be calculated using a tool developed by the European Randomised Study of Screening for Prostate Cancer. This tool can also be used by your Doctor to calculate whether, once diagnosed, a cancer will be aggressive or not.
In a study by Scales et al published in Eur Urol they describe responses from a national health survey (NHANES) completed by 12,100 individuals. 10.6% of men and 7.1% of women reported a history of kidney stones. Obesity, diabetes and race (black and Hispanic) increased the risk. Diet and lifestyle were thought to be key to changing risk.