Volume 14 Issue 2, February 2017

In 2016, immunohistochemical evidence revealed major differences in the inflammatory characteristics of Hunner and non-Hunner interstitial cystitis/bladder pain syndrome (IC/BPS). Evidence has also emerged that an isomer of testosterone, etio-S, might be a urinary biomarker of IC/BPS. Intravesical botulinum toxin injections became a standard treatment of IC/BPS. Furthermore, the International Continence Society has published a new Standard for Terminology for Chronic Pelvic Pain Syndromes.

2016 was an important year for prostate cancer research. New clinical data highlight the need for personalized treatment across clinical disease states and have changed clinical practice for men with metastatic disease. Molecular studies have characterized tumour heterogeneity and informed biomarker development for advanced disease and research into mechanisms of treatment resistance.

The discovery and confirmation of the female urinary microbiota in 2012 provided opportunities to improve insight into lower urinary tract disorders in women, including UTI and urgency urinary incontinence. Now, research in 2016 has shown that expanded culture techniques enable improved uropathogen detection and confirm that bacteria detected by culture-independent methods are alive.

2016 has been a good year for research in non-muscle-invasive bladder cancer. Topics to see progress include risk assessment of patients treated with BCG maintenance, the role of repeat transurethral resection of the bladder (TURB), a prospective study of white-light versus narrow-band imaging, a meta-analysis regarding single instillation chemotherapy, and the effect of the use of fluorescence-guided TURB on progression.

Recent advances have been exciting in the genomics of and targeted therapeutics for renal cell carcinoma (RCC). New agents have been approved for advanced RCC, a novel agent targeting hypoxia-inducible factor 2α has shown considerable promise and molecular characterization of papillary RCC provides the foundation for development of targeted therapeutic approaches for this disease.

Lower urinary tract symptoms (LUTS) are common comorbidities in patients with Parkinson disease, or multiple system atrophy, and these can have considerable negative effects on patients' quality of life. In this Review, the authors describe the prevalence, diagnosis and management of LUTS in patients with PD or MSA, including the key differences in LUTS between patients with these disorders, which can, in some patients, enable a differential diagnosis.

Circulating tumour cells (CTCs) have been studied as biomarkers of a number of urological cancers, although the data are strongest in prostate cancer. CTCs have potential clinical applications in early cancer detection, disease staging, monitoring for recurrence, prognostication, and therapy selection, and might help identify which patients are most likely to respond to androgen-pathway targeted therapies for prostate cancer. In this Review, Gorin and colleagues consider the evidence for a role of CTCs in prostate, bladder, and kidney cancer, and discuss their potential clinical applications.

FOX transcription factors are differentially expressed in bladder cancer subtypes and some are key regulators of embryonic bladder development. Yamashita et al. describe the specific roles of FOX genes and proteins in development and differentiation, and highlight functions in bladder cancer pathogenesis.

Several observational studies support the hypothesis that statin use reduces the risk of advanced prostate cancer. In this Review, the authors discuss molecular mechanisms that might determine this effect, as well as data from clinical studies on associations between statin use and various prostate cancer outcomes, highlighting areas that require further research.

Semen quality in young men has been declining, and shows geographical, as well as temporal, variation. Several aspects of modern life, including lifestyle and environmental factors, stress, and exposure to endocrine disruptors and radiation, could be contributing to these trends. In this Review, the authors describe how semen quality is changing in the 21^stcentury, and consider how we can best identify and avoid the underlying causes.