Volume 16 Issue 5, May 2019

Chronic inflammation in the prostate is a suspected risk factor for prostate cancer. Burns and colleagues implicate chronic inflammation in prostate cancer development, albeit from an unexpected source — the gastrointestinal tract. This new study implicates a history of inflammatory bowel disease with an increased risk of a prostate cancer diagnosis.

Reassurance provided by pre-exposure prophylaxis (PrEP) for HIV might lead to increased sexual risk-taking in men who have sex with men (MSM), potentially increasing the risk of transmitting other infections. A recent study has shown increased transmission of hepatitis C virus (HCV) in this population, suggesting a need for HCV screening.

Multiparametric MRI (mpMRI) has revolutionized prostate cancer diagnosis and risk stratification, but the question remains regarding what it is that we see (or don’t see) on mpMRI. A new study by Houlahan and colleagues now offers insight into the molecular characteristics of a tumour that influence mpMRI visibility.

Results of recent trials have shown the superiority of mpMRI to TRUS-guided systematic biopsy for detecting clinically significant prostate cancer. However, only performing an mpMRI risks missing MRI-invisible lesions and, therefore, there might be added value in performing both targeted and systematic biopsies in biopsy-naive patients.

Continence in nursing home residents declines over time, probably owing to an increase in physical disability and impaired mobility as much as to lower urinary tract dysfunction. A need remains for appropriately skilled assessments of continence care, leading to multicomponent management of continence in this vulnerable group of patients.

In the localized prostate cancer setting, germline BRCA2 mutations confer aggressive clinicopathological features and poor outcomes. This Review discusses the clinical influence of BRCA2 mutations in localized disease, highlighting biological insights into disease aggressiveness from genomic studies and preclinical models.

Ambulatory urodynamic monitoring (AUM) offers numerous advantages over office-based urodynamics for evaluating urological conditions. This Review describes current trends and limitations of traditional urodynamics and advantages of AUM and highlights emerging telemetric AUM devices for bladder pressure and volume monitoring.

In this Review, the authors discuss biomarker-driven prostate cancer molecular subtyping and the development of nanodiagnostic strategies to refine biomarker detection. They also describe the challenges of merging both aspects for precision prostate cancer management.

Macrophage migration inhibitory factor (MIF) can promote tumorigenesis by acting directly on cancer cells and by reversing immunosuppression. Advances have been made in our understanding of the role of MIF in the promotion of, and as a treatment target for, genitourinary cancers.