18/09/2026
Today in Urology - 18 September 2026
Three things worth a minute:
1. Tadalafil and the eye. Among 73,854 men, those prescribed tadalafil or another PDE5 inhibitor for BPH-related LUTS had 22% more glaucoma and 32% more ocular hypertension over five years (Br J Ophthalmol). It's observational, participants were mostly White, and the authors stop short of a contraindication but a glaucoma question before starting daily therapy costs nothing.
2. Hearts before ADT. RADICAL PC-2 randomised 2,487 men to cardiology or internist referral versus usual care. Referral won the composite (win ratio 1.60 over a median 5.8 years), driven by cholesterol control rather than fewer events. The companion analysis points to men with BP above 130/80, diabetes or cholesterol above 4 mmol/L as those who gain most an argument for BP, lipids and HbA1c at the ADT consult.
3. Stones. The 2026 AUA medical management guideline, the first update since 2014, extends to paediatric and adolescent patients and adds genetic testing and extended metabolic evaluation for high-risk formers. An AIIMS Jodhpur series found metabolic abnormalities in 84% of stone formers, with no significant difference between first-time and recurrent cases a case for evaluating after the first stone in our population.
What's changing in your OPD this week?
Dr. Bivek Kumar | Consultant Urologist & Andrologist, Bengaluru
Www.drbivekkumar.com
