Objective: This study aimed to evaluate the role of bone scan as a staging investigation in newly diagnosed untreated prostate cancers. Materials and Methods: Bone scan results in patients with newly diagnosed prostate cancer were reviewed and correlated with clinical stage, prostate-specific antigen (PSA) and Gleason scores from the biopsy specimen. Results: In all, 124 patients fulfilled inclusion criteria with an age range of 51–94 (mean 72.3) years. Pre-biopsy PSA ranged from 2.2 to 5,864 with a median of 21.1 ng/ml. Clinical stage was T0-T1c 14.5%, T2a 41.9%, T2b 17.7%, T3 16.9%, and T4 9%. A Gleason score of 7 was found in 31%. Four patients’ samples were not suitable for Gleason scoring. Twenty patients (16.1%) had a positive bone scan with a mean age of 79.4 years (median 83). Two patients with PSA <20 ng/ml were positive. Of the 44 scans performed in the patients with PSA ≤20 ng/ml, clinical stage

This study gives recommendations to those providing patient care. Emphasises the need for a careful review of all written information with respect to patients' better understanding of the treatment they will receive for the condition being treated.

Background The coronavirus pandemic has had an indisputable impact on surgical training. The qualitative effect on the perceived confidence and capability of trainees has been widely reported. In order to fully delineate the scope of the problem, quantitative data is also required. Methods This cross-sectional study collected compared data on the laparoscopic skills (pre- and post-pandemic) of first-year urology residents in the United Kingdom, who attended the annual Urology Simulation Boot Camp (USBC) in 2018 and 2019 (pre-pandemic), and 2021 (post-pandemic). Results Pre-pandemic group performance was significantly better in 2 out of 4 tasks (Task 3 p < 0.001) (Task 4 p = 0.003) during the practice session. During the assessment, pre-pandemic group performance was better (p = 0.017) for Task 2 and significantly faster (p = 003) for Task 4. Conclusions Our results provide evidence to support the notion that the coronavirus pandemic has had a tangible and detrimental effect on the technical skills of surgical trainees.

Zusammenfassung. Grundlagen: Botulinumtoxin A (BT-A) wird zur Therapie der chronischen Analfissur verwendet. In diesem Review wird versucht, die derzeitigen Ergebnisse in der Therapie der chronischen Analfissur mit BT-A zu beleuchten.Methodik: Studien zum Thema BT-A in der Behandlung der chronischen Analfissur wurden durch eine Medline-Suche identifiziert. Alle relevanten Studien wurden inkludiert. Relevante zitierte Referenzen (cross references) wurden ebenfalls berücksichtigt.Ergebnisse: BT-A hat einen vorübergehenden paralytischen Effekt auf den Schließmuskel. Die Erfolgsraten in der Behandlung der chronischen Analfissur sind unterschiedlich. Langzeitergebnisse mit der Behandlung mit BT-A sind besser als bei Verwendung topischer nitrathäl-tiger Medikamente, allerdings schlechter als nach lateraler Sphinkterotomie. Mehrmalige BT-A-Injektionen sind in vielen Fällen notwendig. Vorteil der Verwendung von BT-A sind die Einfachheit der Applikation und das Fehlen von bleibenden Nebenwirkungen.Schlussfolgerungen: BT-A sollte bei Therapieversagen nach topischen Nitraten und bei hohem Narkoserisiko zur Therapie der chronischen Analfissur bedacht werden. Aufgrund der geringen Komplikationsrate und der vorü-bergehenden Wirkung sollte die Injektion von BT-A vor einer chirurgischen Therapie angeboten werden.All relevant trials, studies, experiences and cross references were included.Results: Botulinum toxin A has a demonstrable temporary paralytic effect on the anal sphincters. A varied rate of success has been observed with its use in management of anal fissures. The long term results are superior to those of exogenous nitric oxide donors and inferior to Lateral internal sphincterotomy. The need for re-injection and high recurrence rate makes it less effective than surgical options but its simplicity and lack of permanent complications make it a desirable option.Conclusions: Botulinum toxin should be considered in uncomplicated idiopathic chronic anal fissures refractory to topical nitric oxide donors and in patients unfit for anaesthesia. In view of its low complication rates and temporary effect on sphincters, it should be offered as an option prior to considering surgical intervention on the anal sphincters.