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- Carlsson, Sigrid, 1982, et al.
(author)
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Improving the evaluation and diagnosis of clinically significant prostate cancer in 2017.
- 2017
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In: Current opinion in urology. - 1473-6586. ; 27:3, s. 198-204
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Journal article (peer-reviewed)abstract
- To provide an overview of the current state of the evidence and highlight recent advances in the evaluation and diagnosis of clinically significant prostate cancer, focusing on biomarkers, risk calculators and multiparametric MRI (mpMRI).In 2017 there are numerous options to improve early detection as compared to a purely prostate-specific antigen (PSA)-based approach. All have strengths and drawbacks. In addition to repeating the PSA and performing clinical work-up (digital rectal examination and estimation of prostate volume), additional tests investigated in the initial biopsy setting are: %free PSA, Prostate Health Index, 4-kallikrein score, SelectMDx, and Michigan Prostate Score and in the repeat setting: %free PSA, Prostate Health Index, 4-kallikrein score, Prostate Cancer Antigen 3, and ConfirmMDx. Risk calculators are available for both biopsy settings and incorporate clinical data with, or without, biomarkers. mpMRI is an important diagnostic adjunct.There are numerous tests available that can help increase the specificity of PSA, in the initial and repeat biopsy setting. All coincide with a small decrease in sensitivity of detecting high-grade cancer. Cost effectiveness is crucial. The way forward is a multivariable risk assessment on the basis of readily available clinical data, potentially with the addition of PSA subforms, preferably at low cost. MRI in the prediagnostic setting is promising, but is not ready for 'prime time'.
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- Grabe, Magnus J., et al.
(author)
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Tailored perioperative antimicrobial prophylaxis in urological surgery : myth or reality?
- 2017
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In: Current Opinion in Urology. - 0963-0643 .- 1473-6586. ; 27:2, s. 112-119
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Research review (peer-reviewed)abstract
- Purpose of review The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed.Recent findings A series of studies have shown that infectious complications and healthcare-associated infections remain consistently at an average of 10%, with a great variation in frequency dependent on the patients' preoperative status and the type, severity and contamination level of the surgical procedure. Preoperative patient assessment and preparation are key factors for well tolerated surgery and recovery. Adherence to the guidelines appears to reduce both the prescription of antimicrobials and the total costs without risking the patient outcome. Several studies of a series of interventions such as cystoscopy, endoscopic stone surgery and selected clean-contaminated interventions give support to the model. Bacteriuria, upgrading the patient to the contaminated level, requires preoperative control.Summary The discussed model assists the urologists in decision-making on perioperative AMP and contributes to a responsible use of antibiotics.
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- Hedlund, Petter
(author)
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Genes and erectile function
- 2003
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In: Current Opinion in Urology. - : Lippincott Williams andamp;amp; Wilkins. - 0963-0643 .- 1473-6586. ; 13:5, s. 397-403
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Research review (peer-reviewed)
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- Hugosson, Jonas, 1955, et al.
(author)
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Overdetection in screening for prostate cancer.
- 2014
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In: Current opinion in urology. - 1473-6586. ; 24:3, s. 256-63
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Journal article (peer-reviewed)abstract
- To describe mechanisms behind and extent of overdetection in prostate cancer screening as well as possible ways to avoid unnecessary overdiagnosis.
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- Messelink, Bert, et al.
(author)
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Chronic pelvic pain; More than just the bladder
- 2024
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In: Current Opinion in Urology. - : Lippincott Williams & Wilkins. - 0963-0643 .- 1473-6586. ; 34:2, s. 69-76
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Research review (peer-reviewed)abstract
- Purpose of reviewChronic pelvic pain is much of a burden to those who suffer from it. Additionally, in many patients medical doctors, such as urologists are unable to identify a cause or clear pathology that can explain the pain. Still numerous patients and doctors keep on searching for a cause, focussing particularly on the pelvic organs. Lots of diagnostics and treatment methods are used but often without success. In recent years, we have gained increased insight into the mechanisms of pain and adapted the terminology accordingly.Recent findingsTwo aspects of chronic pelvic pain have gained more attention. First, the myofascial aspects, especially the role of the pelvic floor muscles in maintaining the pain and as a therapeutic option. Second, the role of the brain and the psychological aspects intertwine with the pain and its consequences also open up for alternative management options. In terminology chronic pain is now included in the ICD-11, a historical change. Introducing chronic primary pain (no cause found) helps us to look away from the organ and deal with the patient as a whole human being.SummaryThe findings reported here are helpful for your daily practice. Looking from a broad perspective gives the patient the feeling of being seen and heard. Working together in a multidisciplinary team makes your work easier and gives more satisfaction.Video abstracthttp://links.lww.com/COU/A44.
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