Volume 8 Issue 5, May 2011

In the past, premature ejaculation (PE) has been considered a psychogenic condition, treated with psychotherapy. Our growing understanding of PE pathophysiology has increased the scientific community's interest in a symptom that is seen across many sexual pathologies. Is it possible to approach PE with traditional medicine approaches, such as acupuncture?

A recent network meta-analysis of α-blockers, antibiotics and other drug therapies for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) found that they provided modest-to-no benefit for this condition, confirming previous findings. However, a casual reading of the article may give a false impression of the efficacy and appropriateness of these drugs.

Radical prostatectomy can damage urinary function, causing incontinence. This incontinence typically resolves by the end of the first postoperative year, but it can be expedited by pelvic floor muscle exercises (PFME). A recent randomized controlled trial has demonstrated that PFME can be effective even when started years after surgery.

As we strive to practice evidence-based medicine, using sophisticated analytical methods to guide our clinical decisions is alluring. Clinicians must, however, be fully aware of the influence of limited data, as with surgical procedures such as pediatric pyeloplasty, and innocent assumptions that could substantially affect the conclusions of such analysis.

Matrix metalloproteinases (MMPs) are a family of enzymes that have a number of important functions, including regulation of the extracellular matrix, angiogenesis and apoptosis. MMP dysregulation has been implicated in several disease processes. In this Review, the authors describe the role of MMPs in bladder cancer, and how these enzymes seem to have potential as diagnostic and prognostic biomarkers or as targets for therapy in patients with this disease.

Although renal cell carcinoma (RCC) is increasing in incidence and is associated with a poor outcome, there is no molecular test to identify which patients will relapse and who will respond to targeted therapies. In this Review, the authors discuss the biochemical, histological and genetic characteristics of RCC, and why these characteristics have not been translated into a useful prognostic and predictive test for patients with kidney cancer.

Over the last decade, inguinal hernia has emerged as a major complication of radical retropubic prostatectomy, with an estimated incidence of 15–20%. Stranne and Lodding have assessed the available data and identified potential risk factors for the development of postoperative inguinal hernia. They also describe a number of possible prophylactic surgical maneuvers.

Gender dysphoria—a condition in which an individual has a severe discontent with the gender they were born with—can be treated with gender reassignment surgery. In this article, Selvaggi and Bellringer draw on their considerable experience to provide an overview of gender reassignment surgery. Both male-to-female and female-to-male surgeries and their associated complications will be discussed as well as the etiopathogenesis of gender dysphoria.

In this Case Study, the authors describe a patient presenting with metastatic bladder adenocarcinoma with intestinal metaplasia. Owing to the tumor's histologic similarities with colorectal cancer, the patient was treated with a FOLFOX chemotherapy regimen.

Hydrogen sulfide is a gaseous transmitter that shares features with nitric oxide (a key gaseous transmitter in erectile function) and has been shown to be involved in vascular homeostasis. In this Perspectives, the authors present available evidence in support of a physiological role for hydrogen sulfide in penile homeostasis and propose that drugs that manipulate this molecule could be an alternative therapy for erectile dysfunction.