Volume 10 Issue 10, October 2013

MRI/ultrasonography (MRI/US)-fusion biopsy outperforms systematic ultrasonography-guided biopsy, detecting more high-grade prostate tumours while being less able to detect low-grade cancer, thus preventing overtreatment of indolent tumours. Any of several MRI-guided biopsy techniques has the potential, therefore, to replace systematic transrectal ultrasonography-guided prostate biopsies in the future.

Robot-assisted laparoscopic sacrocolpopexy (RSC) offers the advantages of minimally invasive surgery, especially to surgeons who do not have laparoscopic expertise. A recently published series adds to the growing body of evidence that RSC achieves comparable outcomes to the open approach with minimal morbidity.

Cryotherapy has the potential to treat recurrent prostate cancer after primary radiotherapy fails. Oncological and functional outcomes of focal versus whole-gland salvage cryotherapy have been examined in a recent study, which demonstrated a positive effect of focal cryotherapy on reducing serum PSA with improved potency and incontinence rates compared with the whole-gland technique.

Deviating from the most widely described approach for robot-assisted radical prostatectomy (RARP), researchers have reported the exceptional outcomes of a Retzius-sparing approach in which they pass through the pouch of Douglas and avoid transecting all structures anterior to the prostate.

In this Review, the authors discuss the novel, technologically advanced radiotherapy modalities for the primary treatment of men with prostate cancer. Advancements in image-guided and intensity-modulated techniques are discussed, focusing on how these modalities contributed to the development of high-dose-rate brachytherapy, stereotactic body radiotherapy and particle beam therapy.

BCG is not a defined strain but a family of regional substrains with marked genetic differences. In this Review, the authors discuss the mechanisms by which BCG immunotherapy induces its antitumour activity and treatment-limiting toxicity, and the effect that genetic and phenotypic differences between BCG substrains might have on these effects.

In this Review, the authors consider the various mpMRI-targeted biopsy techniques that have been used since the introduction of MRI-guided prostate biopsy in 1986, as well as the different aspects of defining and hitting a target, and result reporting for men with treatment-naive prostate cancer undergoing mpMRI-targeted biopsy.

Postoperative infection is one of the most common complications of percutaneous nephrolithotomy (PCNL), and postoperative sepsis is one of the most detrimental. Kreydin and Eisner describe the incidence and pathogenesis of sepsis after PCNL, before discussing the available literature regarding risk factors, prevention and future treatment possibilities.

In this Perspectives article, Elterman et al. discuss the health inequalities that face men in the 21st century and consider ways in which urologists can lead the emerging subspecialty of 'male health'.