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Poster Sessions TABLE OF CONTENTS BAUS Annual Meeting, 25–28 June 2012, BJUI Glasgow, SECC SUPPLEMENTS Poster Sessions Tuesday 26 June 2012 Poster Session 1 11:00–12:30 Alsh PROSTATE CANCER DIAGNOSIS Chairmen: Mr Rick Popert & Mr Garrett Durkan Posters P1–P10 Poster Session 2 11:00–12:30 Carron UPPER TRACT DISORDERS AND IMAGING Chairmen: Mr Toby Page & Mr Chandra Shekhar Biyani Posters P11–P20 Poster Session 3 14:00–16:00 Alsh SCIENTIFIC DISCOVERY Chairpersons: Mr Rakesh Heer & Mrs Caroline Moore Posters P21–P34 Poster Session 4 14:00–16:00 Carron STONES Chairpersons: Mr Daron Smith & Miss Kay Thomas Posters P35–P45 Wednesday 27 June 2012 Poster Session 5 11:00–12:30 Alsh BLADDER CANCER Chairpersons: Ms Jo Cresswell & Mr Rik Bryan Posters P46–P57 © 2012 THE AUTHORS 14 BJU INTERNATIONAL © 2012 BJU INTERNATIONAL | 109, SUPPLEMENT 7, 14–15 TABLE OF CONTENTS Poster Session 6 11:00–12:30 Carron TECHNIQUES AND INNOVATION Chairmen: Mr Ghulam Nabi & Mr John McGrath Posters P58–P67 Poster Session 7 14:00–16:00 Alsh FEMALE UROLOGY AND LUTS Chairpersons: Mr Chris Harding & Miss Mary Garthwaite Posters P68–P82 Thursday 28 June 2012 Poster Session 8 11:00–12:30 Alsh ANDROLOGY Chairmen: Mr Richard Pearcy & Mr Mike Foster Posters P83–P92 Poster Session 9 11:00–12:30 Carron RENAL CANCER Chairmen: Mr Simon Williams & Mr Neil Barber Posters P93–P102 © 2012 THE AUTHORS BJU INTERNATIONAL © 2012 BJU INTERNATIONAL | 109, SUPPLEMENT 7, 14–15 15 POSTER ABSTRACTS Tuesday 26 June 2012 BJUI Poster Session 1 SUPPLEMENTS 11:00–12:30 Alsh PROSTATE CANCER DIAGNOSIS Chairmen: Mr Rick Popert & Mr Garrett Durkan Posters P1–P10 P1 compared with the most affl uent. This biopsies due to uncertainty about their A population based analysis of deprivation gap represents an estimated individual risk of having prostate cancer. socioeconomic circumstances and 1,764 under-diagnosed cases of prostate Biopsies of the prostate are generally safe incidence of prostate cancer cancer over this 5-year period. The but can be associated with signifi cant K Shafi que, R Oliphant, D Morrison signifi cant deprivation gap occurred in low morbidity. We look at whether PSA density Institute of Health & Wellbeing, University grade disease, only. can be used to reliably predict the of Glasgow, United Kingdom Conclusion: The increase in prostate cancer likelihood of having signifi cant prostate incidence among most the affl uent is cancer. Background: It has been suggested that mainly due to an increase in the diagnosis Method: We looked retrospectively at all the higher incidence of prostate cancer of low grade disease. This suggests that patients who underwent diagnostic observed in more affl uent men may be differential use of screening, rather than a template prostate biopsies from April explained by greater use of screening. This true difference in risk of disease, explains 2007–November 2011. Demographic data, study describes trends in overall and the observed deprivation gap. PSA, prostate volume, number of cores, and grade-specifi c prostate cancer incidence by histology results (divided into 1) benign 2) socio-economic circumstances in the West P2 clinically insignifi cant 3) clinically of Scotland from 1991–2007. Can PSA density predict your risk of signifi cant) were collated. PSA density was Methods: Incident cases of prostate cancer having prostate cancer? then correlated with histological results. (ICD-10 C61) from the West of Scotland S Fernando, BSI Montgomery, SJ Bott Results: There were 514 patients with a were extracted from the Scottish Cancer Frimley Park Hospital NHS Trust, Surrey, mean age of 68.4 years. PSA density ranged Registry from 1991 to 2007. Socioeconomic United Kingdom from 0.01 to 1.31. circumstances were measured using the Carstairs score and disease grade (high Introduction: Increasingly, patients with a versus low) was measured using the raised PSA are subjected to prostate Gleason score. Results: In total, 15,519 incident cases of prostate cancer were diagnosed in the West of Scotland between 1991 and 2007. Table for P2 Overall incidence increased by 70% from 44 PSA Density Benign Insignifi cant Cancer Signifi cant Cancer per 100,000 in 1991 to 75 per 100,000 in 2007, an average annual growth of 3.6%. 0.01–0.05 11 (78.6%) 1 (7.1%) 2 (14.3%) Incidence was inversely associated with 0.06–0.15 122 (53.3%) 45 (19.7%) 62 (27.0%) deprivation with the highest rates among 0.16–0.30 105 (50.0%) 24 (11.4%) 81 (38.6%) the more affl uent groups. From 2003–2007, 0.31–0.45 9 (28.0%) 2 (6.2%) 21 (65.6%) the deprivation gap in incidence was 40.3 0.46–0.60 4 (30.8%) 2 (15.4%) 7 (53.8%) per 100,000 (P < 0.001; trend), with rates 0.61–1.31 0 (0.0%) 0 (0.0%) 6 (100.0%) 37% lower among the most deprived © 2012 THE AUTHORS 16 BJU INTERNATIONAL © 2012 BJU INTERNATIONAL | 109, SUPPLEMENT 7, 16–56 POSTER ABSTRACTS The incidence of clinically signifi cant Table for P3 prostate cancer increases with PSA density. Gleason = 4 + 3 Gleason = 3 + 4 MCCL = 6 mm MCLL = 4 mm At lower PSA densities the likelihood of having benign or clinically insignifi cant Target condition 7% (10) 38% (53) 26% (36) 38% (53) disease is far greater than having present, % (N) signifi cant prostate cancer, but still not Sensitivity 93 67 81 70 negligible. Specifi city 63 69 68 71 Of note, no patients with ‘clinically Positive predictive 12 40 32 44 insignifi cant’ cancer have required value treatment to date. Negative predictive 99 87 95 87 value Conclusion: An individual’s PSA density AUC of ROC 0.82 0.71 0.80 0.75 can predict their likelihood of having clinically signifi cant prostate cancer. This information should be used when counselling patients about the need for prostatic biopsy. This may avoid Conclusion: Mp-MRI showed high negative (1–32) and number of cores taken 29 unnecessary biopsies and morbidity. predictive value (87–99%) at all thresholds (16–43). 71 were diagnosed with PCa used. It seems to have ideal attributes as a (51%). 343 (17%) of total 2004 cores were P3 triage test to rule-out clinically important positive, Gleason 6 (20%), 7 (60%) and Can multi-parametric MRI prior to fi rst disease so men could defer a prostate 8–10 (20%). Mean MPC was 51% (1–100), TRUS biopsy rule out clinically important biopsy. ATLPC 51 mm (1–139) and MTL 5 mm prostate cancer? A validating cohort (1–16). PSA, PSAD and %fPSA showed study using template prostate mapping as P4 linear correlation (r = 0.44, 0.54 & −0.36 a reference test Predictive value of PSA, PSAD and %free respectively). AUC for PSA (0.81) was M Abd Alazeez, HU Ahmed, E Anastasiadis, PSA for PCa diagnosis, Gleason score (GS) superior to sPSA and %fPSA (0.76&0.29). M Arya, A Kirkham, M Emberton and Cancer Volume (CaV) in men PSAD predicted GS 7–10 (p = 0.004), MPC University College London Hospital, United undergoing Transperineal Template Guided (p = 0.001), ATLPC (p = 0.002) and MTL Kingdom Saturation Biopsy (TTSB) (p = 0.001). At cut-off of 0.10, PSAD has KC Ekwueme, H Simpson, HD Zakhour, sensitivity 96%, avoiding unnecessary Introduction: Gleason grade and maximum NJ Parr biopsy in 20%. %fPSA was unreliable cancer core length (MCCL) have been used Wirral University Teaching Hospital, United predictor of GS (p = 0.58) and CaV. to risk stratify prostate cancer. We Kingdom Conclusions: PSAD reliably predicts PCa evaluated whether multi-parametric MRI diagnosis, high grade and CaV in men (mp-MRI) could be used to rule-out Introduction and Objective: Persistent undergoing TTSB. PSAD >0.10 has high clinically important disease using different suspicion of PCa despite negative TRUSB sensitivity and value in deciding to offer target defi nitions incorporating grade and presents a dilemma. TTSB is useful, TPSB. MCCL. although expensive and associated with Patients and Methods: 138 men with signifi cant morbidity. To improve predictive P5 elevated PSA and no prior biopsy value of PSA additional serum forms and What is the optimum antibiotic policy for underwent mp-MRI (index test), modifi cations are reported, but are Transrectal Ultrasound guided Prostate (T2-weighted, Dynamic contrast enhanced unreliable in the setting of TRUSB, probably Biopsy? and Diffusion-weighted imaging), followed because the technique fails to detect a PM Thompson, H Nemade, by template prostate mapping (TPM) signifi cant proportion of tumours. We J Philpott-Howard, S Sheehan, W Wang, biopsies (reference test). Analysis was at postulated that predictive values should be S Chandersekara whole-gland level. Four target conditions superior in relationship to TTSB. KIngs College Hospital, London, United were used to represent clinically signifi cant Patients and Methods: A modifi ed TTSB Kingdom prostate cancer; was performed on 139 patients with 1– Gleason = 4 + 3 persistently elevated PSA despite median of Introduction: The infective risk of 2– Gleason = 3 + 4 2 (1–6) negative TRUSB. Prior to TTSB, Transrectal Ultrasound guided Prostate 3– MCCL = 6 mm serum PSA (sPSA), PSAD and %fPSA were Biopsy is well recognised. There remains 4– MCCL = 4 mm documented and evaluated for ability to an unacceptable complication rate of Results: 98/138 (71%) of patients had predict PCa diagnosis, GS and CaV septicaemia with no universally accepted cancer detected by TPM. (maximum % core, MPC, aggregate of antibiotic policy. This study follows the The table displays accuracy fi gures: tumour lengths from positive cores, ATLPC pathway of infection, identifying organisms and maximum tumour length, MTL). and antibiotic sensitivities.
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