UMP and fURS are both safe and effective in the treatment of medium-size urinary stones. Costs for endoscopes and disposable materials are significantly lower in UMP.

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PCA3 is a prostate specific, nonprotein coding RNA that is significantly over expressed in prostate cancer, without any correlation to prostatic volume and/or other prostatic diseases (e.g. prostatitis). It can now easily be measured in urine with a novel transcription-mediated amplification based test. Quantification of PCA3 mRNA levels can predict the outcome of prostatic biopsies with a higher specificity rate in comparison to PSA. Several studies have demonstrated that PCA3 can be used as a prognostic marker of prostate cancer, especially in conjunction with other predictive markers. Novel PCA3-based nomograms have already been introduced into clinical practice. PCA3 test may be of valuable help in several PSA quandary situations such as negative prostatic biopsies, concomitant prostatic diseases, and active surveillance. Results from relevant clinical studies, comparative with PSA, are warranted in order to confirm the perspective of PCA3 to substitute PSA.

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Endourological techniques are used more often nowadays in the treatment of ureteric strictures of various etiologies. Advances in technology have provided new tools to the armamentarium of the endoscopic urological surgeon. Numerous studies exist that investigate the efficiency and safety of each of the therapeutic modalities available. In this review, we attempt to demonstrate the available and contemporary evidence supporting each minimally invasive modality in the management of ureteric strictures.

Abbreviations & Acronyms DO = detrusor overactivity EMG = electromyogram LUT = lower urinary tract LUTS = lower urinary tract symptoms MSA = multiple system atrophy NLUTD = neurogenic lower urinary tract dysfunction PD = Parkinson's disease PMC = pontine micturition center TURP = transurethral resection of prostate Abstract: Parkinson's disease, also known as paralysis agitans, is a progressive degenerative disorder of the central nervous system, with onset usually between the ages of 50 and 65 years, and is associated with loss of dopaminergic neurons in the subsantia nigra and the presence of Lewy bodies. It is characterized by the triad of resting tremor, muscular rigidity and bradykinesia. Often-accompanying abnormalities include disorders of equilibrium, posture and autonomic function, including micturition. Symptoms from the lower urinary tract add a significant comorbidity factor in these patients. The incidence and prevalence of lower urinary tract dysfunction rise with increasing progression of the underlying neurological disease. They present a troublesome and difficult to treat health issue with a profound impact on the patient's quality of life. Storage symptoms seem to predominate. In the long term, renal function might be compromised, mainly as a result of elevated intravesical pressure. Various conservative, minimally-invasive and surgical treatment options are available to prevent harmful sequelae, and to improve the quality of life of these patients. We present an overview of current and prospective treatment strategies.Key words: bladder dysfunction, management, multiple system atrophy, parkinsonism, urinary symptoms. PrevalenceIn the literature, the incidence of NLUTD in PD ranges between 37.9-70% of patients. [1][2][3] In an older study, Gray et al. reported that functional disturbances of the lower urinary tract in PD were not disease-specific and were correlated only with age. 4 Recent, control-based studies in patients with PD have given the prevalence of LUT symptoms as 27-63.9% using validated questionnaires, 5-7 or 53% in men and 63.9% in women, with all of these values being significantly higher than in healthy controls. Ransmayr reported a prevalence of urge episodes and urge incontinence in 53% of Lewy body patients and detrusor overactivity in 46%. 8 In a recent study evaluating disease severity and its relation to urodynamic parameters, 9 the most prevailing symptom was nocturia, followed by urgency and frequency. In most patients, the onset of the bladder dysfunction occurs after the motor disorder had appeared. It has also been shown that voiding dysfunction increases with neurological impairment and not with patient's age or disease duration. 10 PathophysiologySeveral key features have to be taken into account when trying to interpret the mechanisms behind urinary symptoms in PD. The lower urinary tract is subject to supraspinal control. In general, lesions to the PMC frequently result in detrusor hyper-reflexia through loss of the tonic inhibition reflex contraction of the detr...

Objectives: This study aims to assess the impact of a virtual reality trainer in improving percutaneous renal access skills of urological trainees. Methods: A total of 36 urology trainees participated in this prospective study. Initially, they were taken through the exercise of gaining access to the lower pole calyceal system and introducing a guidewire down the ureter. Trainees’ performance was then assessed by virtual reality-derived parameters of the simulator at baseline and after 2 h of training. Results: Participants who underwent training with the simulator demonstrated significant improvement in several parameters compared to their baseline performance. There was a statistically significant correlation between total time to perform the procedure and time of radiation exposure, radiation dose and correct calyx puncture (p < 0.01). Trainees needed a mean of 15.8 min from skin puncture to correct guidewire placement into the pelvicalyceal system before and 6.49 min following training. Conclusions: We found percutaneous renal access skills of trainees improve significantly on a number of parameters as a result of training on the PERC Mentor TM VR simulator. Such simulated training has the potential to decrease the risks and complications associated with the early stages of the learning curve when training for percutaneous renal access in patients.

Background and Objectives:To evaluate the usefulness of laparoscopic varicocelectomy in the management of chronic scrotal pain.Methods:Between 2009 and 2011, 48 patients in total were treated with laparoscopic varicocelectomy for dull scrotal pain that worsened with physical activity and was attributed to varicoceles. All patients were followed up at 3 and 6 months and biannually thereafter with a physical examination, visual analog scale score, and ultrasonographic scan in selected cases.Results:The mean age was 38.2 years (range, 23–54 years). The mean follow-up period was 19.6 months (range, 6–26 months). Bilateral varicoceles were present in 7 patients (14.6%), and a unilateral varicocele was present in 41 (85.4%). The varicocele was grade 3 in 27 patients (56.3%), grade 2 in 20 (41.6%), and grade 1 in 1 (2.1%). The mean preoperative visual analog scale score was 4.8 on a scale from 0 to 10. The mean postoperative visual analog scale score at 3 months was 0.8. After the procedure, 42 patients (87.5%) had a significant improvement in the visual analog scale score (P < .001); 5 (10.4%) had symptom improvement, although it was not statistically significant; and 1 (2.1%) remained unchanged. During follow-up, we observed 5 recurrences (10.4%) whereas de novo hydrocele formation was identified in 4 individuals (8.3%).Conclusion:Laparoscopic varicocelectomy is efficient in the treatment of symptomatic varicoceles with a low complication rate. However, careful patient selection is necessary because it appears that individuals presenting with sharp, radiating testicular pain and/or a low-grade varicocele are less likely to benefit from this procedure.