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To analyse current practice in the management of acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH) in the UK, and to assess how much of this is evidence-based. In all, 410 consultant urologists practising in UK hospitals were sent a questionnaire about the management of AUR secondary to BPH. Data were collected on practice relating to initial management, trial without catheter (TWOC), the use of α-blockers and the follow-up. The need for a uniform guideline in the management of AUR secondary to BPH was also assessed. We received 270 (66%) replies, of which six were excluded because they were from subspeciality interests (e.g. paediatric urology) or had ambiguous answers; 264 (64%) were therefore available for analysis. Urethral catheterization was the initial management of choice (98%), failing which a suprapubic catheter was inserted. Two-thirds (65.5%) admitted the patient after catheterization. Most consultants initiated α-blockers (70.5%), with 64% (118) of these using a TWOC 2 days after starting them. One failed TWOC was an indication for transurethral resection of the prostate for 192 (72.8%), with 136 (49.8%) re-admitting the patient for surgery later. Routine follow-up after a successful TWOC was advocated by 77.3%. Just over half the respondents (52.6%) felt that there was no need for uniform guidelines in the management of AUR secondary to BPH. This survey identified a reasonable national uniformity in managing AUR secondary to BPH in the UK, but significant aspects of current practice are not evidence-based. [ABSTRACT FROM AUTHOR]

OBJECTIVE To recommend a standard technique for the renographic evaluation of the dilated upper urinary tract, and for evaluating the results of surgery. METHODS This review is an update of the previously recommended consensus report of the 9th International Symposium of Radionuclides in Nephrourology. RESULTS State-of-the-art recommendations are detailed for standardizing common radionuclide investigations. CONCLUSIONS Where open, laparoscopic or endourological techniques for treating pelvi-ureteric junction obstruction are under study, results can only be compared by standardizing the investigational techniques. The guidelines produced here are recommended for this purpose. [ABSTRACT FROM AUTHOR]

Objectives To evaluate whether the short‐term prostate‐specific antigen (PSA) velocity before biopsy can be used to predict prostatic histology, and to assess the role of a second PSA measurement before prostate biopsy. Patients and methods The study comprised 197 patients who were referred for transrectal ultrasonography (TRUS) and prostate biopsy. The PSA level was initially measured at the first outpatient assessment; patients with a serum PSA level of < 4 ng/mL and > 50 ng/mL were excluded. Blood samples were taken just before prostate biopsy for the second PSA measurement. The mean interval between the measurements was 2.2 months. The short‐term PSA velocity was calculated and correlations between this variable and age, prostate volume and initial PSA levels determined. Results There was a statistically significant difference between the short‐term PSA velocity of patients with benign prostate histology and those with prostate cancer (P < 0.05). The short‐term PSA velocity alone had the same diagnostic accuracy as the serum PSA level (area under the receiver‐operating characteristic curve 0.612). There was only a weak correlation between the short‐term PSA velocity and prostate volume. However, there was no correlation with age and initial PSA level in patients with benign histology. The second PSA measurement had higher specificity without losing sensitivity. Conclusion The short‐term PSA velocity estimated before biopsy can be used to predict prostatic histology. By measuring serum PSA 2 months after the first in patients with serum PSA level of 4–10 ng/mL, the number of negative biopsies can be reduced by 17%. [ABSTRACT FROM AUTHOR]

Examines the renographic and operative findings of pressure chronic retention among patients. Progress of renal impairment; Occurrence of bilateral hydronephrosis and hydrourer; Symptoms of outflow tract obstruction.

Examines the role of modern radiological investigations in obstructed urinary tract. Determination of the renal blood flow and glomerular filtration rate; Evaluation of the urinary tract dilatation; Effects of obstruction on ureteric reflux.

Objective To assess the effect of prostatic manipulation on complexed prostate‐specific antigen (cPSA), as various forms of prostatic manipulation are known to increase the serum free and total PSA level. Patients and methods A series of 92 men (58 after prostatic biopsy, 16 after digital rectal examination and 18 after flexible cystoscopy) were assessed. Blood samples were taken from each patient before and 30 min after manipulation. Total and cPSA levels were measured using appropriate assays, respectively. Results There was no significant increase in cPSA levels after flexible cystoscopy and digital rectal examination, but prostate biopsy caused a statistically significant although minimal rise in cPSA level. There was no statistically significant increase in cPSA level after prostate biopsy in patients with prostate cancer (P = 0.35) although there was a statistically significant but minimal rise in cPSA level in patients with benign histology (P < 0.01, mean increase 2.13 ng/mL) compared with that of total PSA, which increased markedly (P < 0.01, mean increase 19.79 ng/mL). Conclusion Prostatic manipulation has minimal effects on cPSA levels. [ABSTRACT FROM AUTHOR]

Examines the method in determining the glomerular filtration rate. Use of an x-ray fluorescence technique in measuring disappearance; Measurement on the clearances of chromium-51 labeled edetic acid; Correlation between the creatinine clearance and clearances of chromium-51 labeled edetic acid.

Compares the use of radionuclide, ultrasound, and computed tomographic scanning in investigating renal space-occupying lesions. Clarification of the nature of lesions; Effectiveness of the methods on the investigation; Advantages and disadvantages of the methods.