Volume 13 Issue 9, September 2016

Testosterone therapy for men with prostate cancer is a controversial topic. A recent study retrospectively reviewed a single-centre experience in treating hypogonadal men with prostate cancer with exogenous testosterone therapy and found it to be safe.

The speed with which PSMA PET–CT has been adopted for prostate cancer imaging is unprecedented. This technique's clinical value in recurrent disease is uncontested, but its role in initial staging is unclear. Two studies now provide important data on the value of PSMA PET–CT at this management stage.

In kidney transplantation, the tremendous shortage of organs is a major problem and an ongoing concern is whether any procured but discarded kidneys could have been successfully transplanted. A recent study investigated whether kidney procurement rates from deceased donors are reduced and discard rates are increased at the weekend.

Simulation has become widely accepted as a supplementary method of training in urological skills, with the greatest number of procedure-specific models and subsequent validation studies carried out in the field of endourology. Skills simulators have been created for laparoscopic and robot-assisted surgery, but only a limited number of validated models are available for open procedures. In this Review, Aydin and colleagues discuss the various modalities of simulators available to urologists and suggest a curriculum for structured surgical training.

Overactive bladder in children is a surprisingly common syndrome that can persist into adulthood. Evidence increasingly suggests that this syndrome can be explained by neurological changes or comorbidities. Here, the author describes the causes, symptoms and management of paediatric patients with overactive bladder.

Robot-assisted radical cystectomy (RARC) is an evolving technique for the treatment of muscle-invasive bladder cancer (MIBC); however, its effectiveness compared with open radical cystectomy is debated. In this Review the authors discuss the specific areas of evidence that are critically important for supporting the continuing use of RARC for MIBC and the considerable progress that has been made in this regard.

Miah and colleagues discuss differences between Gleason pattern 3 and pattern 4 prostate cancer that make the designation of pattern 3 disease as a lethal disease uncertain and argue in favour of dropping the label cancer for Gleason score 3 + 3 = 6 tumours.

Despite large numbers of patients being affected by stones, a surprising lack of knowledge exists on the relevance of stone compositions and pathological features to the outcomes of patients with stones. Here authors describe the potential of new technologies such as high-resolution endoscopes, and micro-CT imaging to address this lack of knowledge.