Volume 13 Issue 10, October 2016

Some urologists might be surprised that the urinary tract is not sterile, and bacteria might have important roles in a number of urological conditions such as urge incontinence. This paradigm shift, which has been further illustrated by data from a recent study, has implications for how urologists diagnose disease and treat patients.

METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) is the first effort to provide the burgeoning field of whole body-MRI (WB-MRI) with minimum standards of image acquisition, interpretation, and reporting; it should act as a catalyst for promoting the use of this promising method.

The American Urological Association, the Society of Urologic Oncology and the European Association of Urology have recently updated their guidelines for diagnosis and treatment of non-muscle-invasive bladder cancer. Several studies show that adherence to these guidelines is low, especially in North America. Physicians should try to comply with these guidelines to ensure optimal quality of care.

Nocturia is a very common condition with major sequelae for affected patients. It leads to impaired quality of life and is associated with numerous morbidities including diabetes, coronary artery disease, obstructive sleep apnoea, obesity, metabolic syndrome, and depression. In this Review, the authors discuss the clinical relevance of nocturia and the need for treatment. They describe the various aetiologies of the condition and discuss a contemporary approach to its treatment and management, including methods to tailor treatment strategies to individual patients.

In this Review, the authors summarize current knowledge of sperm-specific epigenetic signatures and diet-induced epigenetic effects on sperm quality. They also discuss transgenerational effects of the sperm epigenome on offspring health.

Proteomic and biochemical studies on cervical-vaginal fluid (CVF) have revealed that it contains several members of the tissue kallikrein-related peptidase (KLK) family. The roles of KLKs in the lower female reproductive system are not fully understood. In this Review, Muytjens and colleagues discuss the putative roles of KLKs in vaginal fluid and how increased understanding of their function could result in new diagnostic and therapeutic modalities.

Medical expulsive therapy (MET) has been widely used for the management of ureteral stones for the past two decades, despite limited evidence on the effectiveness of this approach. In the past year, data from two clinical trials has called the continued use of MET into question. Here, the authors consider the role of MET in the managment of ureteral stones, in light of this improved level of evidence.

The prostate is an immune-competent organ and several stimuli have been identified as possible triggers for dysregulation of the prostatic immune system via molecular pathways involving the development of inflammatory infiltrates. From a pathophysiological standpoint, subsequent tissue damage and chronic tissue healing could result in the development of BPH nodules. In this Review, the authors discuss the immunopathology of BPH and consider its links to prostate cancer and other disorders from an immunological viewpoint.