In an article by Thangasamy et al published in Eur Urol (2012) the authors describe the results of a meta-analysis of the results of photoselective vaporisation of the prostate (PVP) also known as Green Light Laser prostate surgery, compared to Transurethral resection of the prostate (TURP). 9 trials were identified with 448 patients treated with PVP, and 441 with TURP. Period of post-op catheterisation, blood loss and blood transfusion were significantly better with PVP, although operating time was longer. Regarding functional outcomes, 6 studies found no difference, 2 favoured TURP and 1 favoured PVP, with variable follow-up between 6 and 36 months.

The Redeem study was set up to investigate whether dutesteride is effective in treating men with low risk (PSA <11 and Gleason score 6 or less)  prostate cancer. Results published in Lancet (2012) suggest that, in this randomised controlled double blind trial of 302 pateints (147 actively treated with 155 matching placebo treated men), prostate cancer progression was reduced in those patients recieving 0.5mg dutesteride daily. Approximatly 1/3 of the treated patients progressed compared to 1/2 of those not treated. Mortality and adverse events were similar in both groups at 3 years.

In an interesting case-control studyby Wright et al published in Cancer (2012) the authors found a 15% reduction in prostate cancer risk in patients circumcised before first sexual intercourse. The study included 1754 prostate cancer cases and 1645 controls. Approximately 17% of all cancers are caused by infection and there is already other epidemiological evidence linking sexually transmitted infection (STI) to prostate cancer. This publication reinforces the causal relationship between STI and prostate cancer.

In a meta analysis of 13 randomised trials published in Arch Int Med (2012) the authors showed that Cranberry products probably do help prevent urinary tract infections. A significant effect emerged from pooled analyses that excluded one outlying trial (risk ratio 0.62, 95% CI 0.49 to 0.80), confirming results from a previous much smaller meta-analysis. The effect is greatest for individuals taking more than 2 doses per day, younger women and children. The effect is less strong for the elderly, pregnant and patients with neuropathic bladder dysfunction. Cranberries (genus Vaccinium) have been used as a natural remedy for at least 100 years, and in the 1980s scientists discovered that the berries contain an active ingredient (possibly proanthocyanidins) that stops bacteria sticking to uroepithelial cells.
In a separate report published as a Cochraine review (2012) the researchers concluded that current evidence did not support a preventative role for cranberry juice.

In an article published in N Eng J Med (2012) Wilt et al investigated radical prostatectomy as a treatment for localised prostate cancer and report results from this research known as the PIVOT trial. Radical prostatectomy did not significantly reduce mortality compared to active surveillance during 10 years of follow-up (171/364 (47%) v 183/367 (49.9%) and made no significant difference to risk of death from prostate cancer or its treatment. The men had localised disease (half the tumours were impalpable) and a median prostate specific antigen concentration of 7.8 μg/L. Four fifths of the men who had surgery were unable to have erections afterwards (231/285 (81%)), and one in six was incontinent (49/287 (17%)). This article suggests that active surveillance is a good treatment for low risk prostate cancer. However, radical prostatectomy improved all cause mortality in patients with a PSA greater than 10ng/ml (p=0.04) and probably in those with intermediate/high risk disease (p=0.07).

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.