BPH: Black box warning for tamsulosin? | PDF (127 KB)
p345 | doi:10.1038/nrurol.2009.116
Table of contents
July 2009 Vol 6 No 7
Research Highlights
Prostate Cancer: Tumor cells driven to suicide by inactivated virus | PDF (84 KB)
p346 | doi:10.1038/nrurol.2009.114
In brief
Prostate cancer | Prostate cancer | Prostate cancer | Pathology | PDF (46 KB)
p346 | doi:10.1038/nrurol.2009.121
Risk factors: Glutathione S-transferase polymorphism and prostate cancer | PDF (53 KB)
p347 | doi:10.1038/nrurol.2009.112
Prostate cancer: Molecular markers and prognosis | PDF (47 KB)
p347 | doi:10.1038/nrurol.2009.120
Speak plainly about prostate cancer | PDF (45 KB)
p347 | doi:10.1038/nrurol.2009.71
TURP OK for BPH in Parkinson disease | PDF (48 KB)
p348 | doi:10.1038/nrurol.2009.115
Urinary incontinence: Behavioral intervention enhances pharmacological therapy | PDF (78 KB)
p348 | doi:10.1038/nrurol.2009.117
Surgery: Laparoscopic versus open nephroureterectomy | PDF (99 KB)
p349 | doi:10.1038/nrurol.2009.118
In brief
Surgery | Male factor infertility | Male factor infertility | Pediatrics | PDF (45 KB)
p349 | doi:10.1038/nrurol.2009.122
Prostate Cancer: Type of biopsy probe determines detection rate | PDF (74 KB)
p350 | doi:10.1038/nrurol.2009.113
Prostate cancer: New endothelin-A receptor antagonist prolongs survival | PDF (50 KB)
p350 | doi:10.1038/nrurol.2009.119
Correction: Integrative medicine: complementary therapies and supplements | PDF (43 KB)
p350 | doi:10.1038/nrurol.2009.128
News and Views
Urinary Incontinence: Oxybutynin topical gel for overactive bladder
Christopher R. Chapple
p351 | doi:10.1038/nrurol.2009.111
Antimuscarinic drugs are the first-line treatment for overactive bladder. However, traditional formulations are associated with a number of adverse effects, most notably dry mouth. A study comparing a new topical gel formulation of oxybutynin to placebo has confirmed its efficacy and tolerability for treating overactive bladder.
Surgery: Centers of excellence for penile prosthesis: yes or no?
Tariq F. Al-Shaiji & Gerald B. Brock
p352 | doi:10.1038/nrurol.2009.109
Emerging data indicate that outcomes of surgical procedures are improved if surgery is performed in high-volume hospitals or by high-volume surgeons. This principle seems to hold true for penile prosthesis surgery, but careful consideration is necessary before adopting a 'center of excellence' model for this, or any, procedure.
Clinical trials: Nationally representative data in urology
Jay B. Shah & Vitaly Margulis
p354 | doi:10.1038/nrurol.2009.104
Retrospective analyses of single-institution experiences are difficult to generalize to the population as a whole. The emerging trend of utilizing national datasets and disease registries provides information relatable to the average patient that may prove considerably more useful to community urologists.
Risk factors: Improved risk stratification for prostate cancer
Hendrik Isbarn & Pierre I. Karakiewicz
p355 | doi:10.1038/nrurol.2009.106
An algorithm used to evaluate risk in patients with prostate cancer has been improved by taking into account the quantity of risk factors present. The adapted scheme accurately predicts disease-specific mortality, and reveals that prostate cancer is the major cause of death in patients with three or more risk factors.
Genetics: Susceptibility loci in a molecular subtype of prostate cancer
Robert J. Klein
p357 | doi:10.1038/nrurol.2009.108
Genetic linkage has recently been reported between several genomic loci and a subtype of prostate cancer that contains a fusion between the genes TMPRSS2 and ERG. These data suggest an analytical approach that might improve future studies of the genetic cause of prostate and other cancers.
Clinical guidelines: Should 5
-reductase inhibitors be used for prostate disease?
Noel W. Clarke
p358 | doi:10.1038/nrurol.2009.105
A new guideline from the US has neatly summarized the evidence regarding the use of 5
-reductase inhibitors for prostate disease, but falls short of providing definitive management recommendations. It will, however, be a valuable aid to both patients and physicians in the clinical decision-making process.
Pain: Easing the pain: local anesthesia for prostate biopsy
Katsuto Shinohara
p360 | doi:10.1038/nrurol.2009.110
The importance of prostate biopsy is undisputed, but the procedure can be excruciatingly painful for some men. Does combined anesthesia aimed at addressing the two sources of pain associated with transrectal ultrasound-guided prostate biopsy provide a more effective form of pain relief than either modality alone?
Surgery: Laparoscopic prostatectomy: learning curve and cancer control
Steven L. Chang & Mark L. Gonzalgo
p361 | doi:10.1038/nrurol.2009.107
Greater surgeon experience is associated with lower recurrence rates following laparoscopic radical prostatectomy for prostate cancer. A new study shows that the learning curve for this procedure is slower than that for open surgery, and highlights the challenges of developing the unique skills that are required to master each technique.
Reviews
Contemporary imaging of incidentally discovered adrenal masses
Milton D. Gross, Melvyn Korobkin, Wessam Bou Assaly, Ben Dwamena & Mehdi Djekidel
p363 | doi:10.1038/nrurol.2009.100
Modern, high-resolution imaging modalities frequently reveal adrenal masses in patients being assessed for other reasons. Once discovered, algorithms that employ CT, MRI and PET—as well as modifications of these techniques—are used to narrow the very broad differential diagnosis. Here, Milton Gross and colleagues summarize what the urologist needs to know about the imaging features of etiologically distinct adrenal masses.
Cytoreductive nephrectomy for metastatic RCC in the era of targeted therapy
E. Jason Abel & Christopher G. Wood
p375 | doi:10.1038/nrurol.2009.102
The development of targeted therapy for renal cell carcinoma (RCC) has changed the treatment options for patients with metastatic RCC. The authors of this Review discuss the current and future role of cytoreductive nephrectomy in combination with targeted therapies, and the rationale for presurgical therapy for this group of patients.
Prostate kallikrein markers in diagnosis, risk stratification and prognosis
David Ulmert, M. Frank O'Brien, Anders S. Bjartell & Hans Lilja
p384 | doi:10.1038/nrurol.2009.123
The discoverer of free PSA and his colleagues assess the clinical utility of this most widely used disease biomarker. The article encompasses recently published data from randomized screening trials, and the potential of PSA density, dynamics and subforms to enhance the predictive capacity of total PSA. The PSA characteristics of BPH, prostatitis and prostate cancer are summarized, and the effects of age and obesity presented.
Case Study
A G-CSF-secreting adrenal carcinoma with rhabdoid-like differentiation causing leukocytosis
Emil Lou, Jeremy Goodwin, David N. Howell, John Hicks & L. Brett Caram
p392 | doi:10.1038/nrurol.2009.101
The authors describe a 57-year-old man with paraneoplastic leukocytosis, caused by overexpression of granulocyte-colony stimulating factor from a suprarenal tumor with rhabdoid-like differentiation. This case presented several diagnostic and treatment challenges to the pathologists, surgeons, and oncologists involved, and illustrates the difficulties encountered when diagnosing and treating unusual malignancies.
Perspectives
Opinion
A management algorithm for hematospermia
Muhammad I. Aslam, Philippa Cheetham & Marek A. W. Miller
p398 | doi:10.1038/nrurol.2009.98
The causes of blood in the ejaculate are usually benign, and the condition self-limiting. Nevertheless, many patients are worried by such a dramatic symptom. This concern, together with the small risk of malignancy, drives clinical investigation. UK-based authors have reviewed the literature in an effort to provide a clear and concise strategy for the evaluation of men with hematospermia.
