Volume 13 Issue 3, March 2016

Biomarkers predicting response to chemotherapy in patients with muscle-invasive bladder cancer (MIBC) have the potential to better select patients for treatment and to improve outcomes of this aggressive disease. Results from a new study bring us a step closer to individualizing treatment through use of a three-gene signature to predict response to neoadjuvant chemotherapy.

Androgen deprivation combined with external beam radiotherapy improves the overall survival of patients with localized prostate cancer but might be associated with adverse effects that influence their health and quality of life. When considering this medication, clinicians must be aware of the increased risk of cardiac mortality in patients with moderate or severe comorbidity.

Tolvaptan, an arginine vasopressin receptor antagonist, decreases urinary supersaturation in kidney stone formers by considerably increasing diuresis, suggesting that this drug might be an effective therapy for reducing the risk of developing kidney stones in these patients.

Mirabegron has been shown to cause relaxation of the isolated mouse urethra, partly through blockade of α_1A-adrenoceptors and α_1D-adrenoceptors. However, although this effect might be an interesting pharmacological in vitro observation, it seems to have no relevance for the clinical use of mirabegron in the treatment of the overactive bladder.

Testosterone supplementation therapy is an effective therapy for hypogonadism but can lead to the suppression of spermatogenesis. A new study investigated the effects of enclomiphene citrate, the trans isomer of clomiphene, on serum hormone levels and sperm counts in men with secondary hypogonadism.

The development of the ureteral access sheath (UAS) has enabled substantially greater use of ureteroscopy for minimally invasive management of diseases of the upper urinary tract. Here, the authors describe the advantages and risks associated with the routine use of UAS, and the potential for use of UAS by endourologists for a wider range of applications.

Testicular biopsy is not routinely performed in children, mainly because of concerns about damaging the developing gonad. In this Review, the authors describe how testicular biopsy could be useful for predicting fertility potential in prepubertal boys with undescended testes and also for assessing malignancy risk in these patients and those with disorders of sexual development. The authors also discuss the promise of cryopreservation of testicular tissue samples for the preservation of fertility in prepubertal boys receiving gonadotoxic chemotherapy.

Active surveillance of men with prostate cancer has received increasing interest over the past decade, resulting in the publication of a wide range of different guidelines on the management of patients in active surveillance programmes, often with very different recommendations. Here, authors describe the various available guidelines and how they differ from each other, highlighting the need for an international consensus on the optimal use of active surveillance in patients with prostate cancer.

Erectile dysfunction (ED) has detrimental effects on the quality of life of affected individuals and their sexual partners. Physicians, nurses, and clinical educators should consider this disorder as a shared health problem for the couple, and sexual partners have an important role in its management.