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BACKGROUND: Surgical education has embraced advancing technology with an emphasis on e-learning in recent years. Smartphones are a useful tool for medical teaching and learning with increasing use by medical students to access e-books, medical calculators, podcasts, and medical applications (apps). Our aim was to develop a dedicated urology app for medical students as an adjunct to traditional teaching. METHODS: We published an e-book: Urology Handbook for Medical Students in 2017 based on the core urology curriculum for medical students. Subsequently, we developed a concise, simple and user-friendly smartphone app for medical students called "Urology Med", available for download on App Store and Google Play. RESULTS: This app is an introduction to urology for medical students but may also be useful for interns and surgical trainees. The app encompasses core urology topics subdivided into common urological presentations, urological examination, urological diseases, and urological devices. To make the app interactive, it includes 5 clinical cases that complement the reading material and six quizzes for self-assessment. A comprehensive checklist of 31 "must see" and "good to see" urology experiences is included. Within one month of launch, the app was downloaded 435 times in five countries across three continents. It has a 5-star rating on the Apple store. CONCLUSIONS: High educational standards with relevant content make e-learning a valuable learning tool for surgical education. The Urology Med app facilitates easy access to urology and is ideal for quick reading while working or revising.
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INTRODUCTION: Reliable quantification of prostate volume is important to correctly select patients with benign prostatic hyperplasia (BPH) most likely to benefit from medical therapy [e.g. 5 alpha-reductase inhibitors (5-ARIs)] and in selecting appropriate surgical approach. We aim to determine the reliability of digital rectal examination (DRE) in estimation of prostate volume which may be helpful in patient selection for 5-ARIs therapy. MATERIALS AND METHODS: Patients requiring transrectal ultrasound (TRUS) guided prostate biopsy were recruited in this prospective study. DRE was performed twice for each patient. Clinicians categorized prostate volume on DRE into small, medium and large, and estimated prostate volume. Volume estimated by DRE at the first examination was intentionally unavailable at second DRE. TRUS volumes were measured using 2101 Falcon ultrasound machine. RESULTS: Comparative analysis of prostate volume (n = 248) by DRE and TRUS was performed. There was no significant difference between DRE-estimated prostate volume at the first and second examinations (p = 0.8). DRE-estimated volumes for prostates categorized as small, medium or large were underestimated in 59%, 58% and 53% of patients respectively. However, for clinical relevant volumes (> 30 cc), 94.5% patients were accurately estimated on DRE. CONCLUSIONS: We have shown that DRE had positive predictive value of 94% in identifying prostate above 30 cc. Hence, when considering treatment with 5-ARIs, DRE may be sufficient to identify suitable patients for 5-ARIs therapy. However, for prostate volumes between 25 cc-30 cc and above 80 cc, TRUS may be required.
