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Screening for prostate cancer decreases the risk of metastatic disease at 12 years follow up.

In an article by Shroder et al published in Europe Urol (2012), the authors publish results from the European randomised study of screening for prostate cancer. They report that screening significantly reduces the risk of developing metastatic disease in the 76813 men with available data. At 12 years follow up 256 screened men and 410 control men had developed metastasis. This was a relative risk reduction of 30% or 3.1 per 1000 men randomised (42% in the intention to screen analysis).

Screening for prostate cancer using the PSA blood test remains amongst the most controversial subject in Urology, but this data adds significantly to the body of evidence supporting screening.

What is “No Scalpel vasectomy” and does it have advantages?

“No Scalpel Vasectomy” was developed in China by Dr. Li Shunqiang 40 years ago. Since introduction over 15 million no-scalpel vasectomies have been performed throughout the world. As the name suggests, the “No Scalpel” method does not involve a scalpel, but a small opening is still necessary. The key to this technique is the special small pointed forceps used to create a tiny hole in the skin, instead of a scalpel incision. As with a conventional procedure, the vas deferens is then located and delivered through the hole, before a segment is removed. Generally the hole in the skin is closed with a suture or glue, but may be small enough to be left to heal spontaneously.

Surgeons who perform the No Scalpel method of vasectomy believe that their procedure produces less complications and discomfort with less bruising, smaller vasectomy scars, and faster recovery time. Other Surgeons who continue to use the standard technique may not believe that there is a significant advantage.

Our Consultants perform both Scalpel and No Scalpel Vasectomies, depending on which procedure is most suitable. Please contact us to make an appointment to discuss this further with one of our experienced Consultants. For further information about Vasectomy click here.

Incidence of rare subtypes of prostate cancer

In an article published in Prostate and Prostatic Diseases the authors describe the relative incidences of rare subtypes of prostate cancer.

Incidence rate per million for rare prostate cancer subtypes

All Caucasian African American Rate ratio P-value
Mucinous 0.61 0.56 1.36 2.81 <0.01 Ductal 0.49 0.49 0.61. 1.24 0.26 Signet cell 0.08 0.07 0.15 1.80 0.14 Neuroendocrine 0.35 0.34 0.51 1.47 0.07 Adenosquamous 0.03 0.03 0.02 0.91 1.00 Adenocarcinoma 586.0 571.9 874.9 1.49 <0.01

Bladder neck preservation during radical prostatectomy improves continence

In an article by Nyarangi-Dix et al published in J Urol (2012), the authors show that continence is better in patients treated by bladder neck preservation during radical prostatectomy than those without bladder neck preservation. They conducted a randomised study involving 208 men treated with radical prostatectomy at their institution. The patients did not know if they had the complete bladder neck preservation (cBNP) procedure or not. All the patients completed 12 months of follow-up. After excluding nine subjects, the analysis included 95 men who were assigned to cBNP and 104 non-BNP controls.

Surgical margin positivity rates were not significantly different between the two groups at 14.7% and 12.5%. Rates of social continence – defined as use of no more than one pad per day – were 84.2% vs 55.3% (p<0.001) at three months and 94.7% vs 81.4% (p=0.027) at 12 months, favouring cBNP. This study confirms many previous reports from retrospective data, and is similar to results from patients treated at the Staffordshire Urology Clinic.

Percutaneous Tibial Nerve Stimulation (PTNS); a revolutionary new treatment for Urge urinary incontinence

The Staffordshire Urology Clinic has recently introduced PTNS. This is a non-drug, non-surgical, minimally invasive way to improve bladder control in men and women. This revolutionary new technology has been shown to be highly effective even in patients that have not responded to conventional medication, and avoids the side effects of such medicines. Although PTNS is increasingly used throughout the world, it is not currently offered elsewhere in Staffordshire, Shropshire or South Cheshire. To find out more, click here, or make an appointment to see one of our Consultants.