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ORIGINAL PAPERIncidental urinary tract pathologies in the one-stopprostate cancer clinic.Mohammed Aza 1 , S. Shergill Iqbal 2 , M. Vandal Muhammad 2 , S. Gujrai Sandeep 21Gartnavel General Hospital, Glasgow, UK;2King George Hospital, Essex, UKSummaryObjective: We determined the prevalence of incidental urinary tract pathologies inpatients referred to the one-stop suspected prostate cancer clinic and assessed the evaluationand outcome of these pathologies.Methods: One hundred and ninety patients were referred to the one-stop suspectedprostate cancer clinic over a 6-month period. The records of patients with incidental urinarytract pathologies were retrospectively reviewed for demographic characteristics, mode of clinicalpresentation, further investigations performed, the final diagnosis and the treatment given.Results: Incidental urinary tract pathologies were detected in 12 patients (6.3%). Clinically significantpathologies were found in 4.7% patients (n = 9). Significant incidental findings includedbladder cancers (n = 8) and renal cell carcinoma (n = 1). All of these patients had additionaldiagnostic investigations, required in-patient surgical treatment and have remained diseasefree at follow up. Trans-rectal ultrasound guided prostate biopsies were only performed in threecases and a diagnosis of prostate cancer was only made in one patient.Conclusion: Incidental urinary tract pathologies among patients referred to the one-stop suspectedprostate cancer clinic are common. This reflects the need for further investigating patients withlower urinary tract symptoms whenever necessary so avoid missing significant pathologies.KEY WORDS: Prostate cancer; PSA; Incidental pathologies; Clinics.Submitted 15 September 2009; Accepted 10 December 2009INTRODUCTIONWith the introduction of new UK Department of Healthtargets for the detection and treatment of cancer (1),patients with suspected prostate cancer are referred to aone-stop clinic and seen by a Consultant within 2 weeks.During the first six months of the introduction of theone-stop suspected prostate cancer clinic at our institution,it was noticed that amongst those correctly referred,some patients had additional incidental urinary tractpathologies which were not evident at the time of referral.In the absence of a strong literature base for this finding,we determined the prevalence of incidental urinarytract pathologies in patients referred to our one-stop suspectedprostate cancer clinic, and assessed the evaluationand outcome of these patients.METHODSAll patients referred to our one-stop suspected prostatecancer clinic were thoroughly evaluated with full medicalhistory and physical examination including a digital rectalexamination. Referral criteria were strictly based on theNorth East London Cancer Network guidelines (4), modifiedfrom the National Institute of Clinical Excellence(NICE) urological cancer guidance in England (5). Transrectalultrasound-guided prostate biopsies (TRUS-Bx) wereperformed, at the same visit, if appropriate. Subsequently,the records of patients who were found to have incidentalurinary tract pathologies on subsequent investigationswere reviewed retrospectively for demographic features,mode of clinical presentation, further investigations performed,final diagnosis and its clinical significance, as wellas treatment given. Incidental urinary tract pathologieswere defined as abnormalities of the kidneys, collectingsystem, ureters, bladder, urethra and external genitalia(penis and testes), that were not known at the time of referralto the one-stop clinic and were only discovered withfurther evaluation of those patients. Clinical significancewas considered high when a diagnosis of cancer was made,Archivio Italiano di Urologia e Andrologia 2010; 82, 115