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The management of uncommon urological malignancies is rarely based on evidence from prospective trials, and ad hoc treatment by individual clinicians who seldom encounter the cancer is not ideal for the patient. In this article, Nicholson identifies key issues in developing a trial strategy for treating rare urological malignancies.
In this Viewpoint, the authors discuss the FDA's strategies for increasing access to new medicines for patients with serious or life-threatening illnesses. The article describes the currently available access mechanisms, and highlights the FDA's planned regulation revisions for expanding access.
Sacral neuromodulation (SNM) has been investigated as a treatment for a range of refractory lower urinary tract disorders. In this Review, Kessler and Fowler discuss developments in SNM techniques and technology, assess patient outcomes, and consider potential mechanisms of action for this therapy.
Urinary tract stones and urinary tract infection are strongly associated. In this Review, Thomas and Tolley describe the pathogenesis, diagnosis and management of infection stones, and also the management of patients who develop infections as a consequence of stone disease.
The integration of molecular biomarkers into prediction models has the potential to improve the management of urothelial carcinoma of the bladder. Bolenz and Lotan outline the search for candidate biomarkers in this disease, and discuss the obstacles to their use in routine clinical practice.
In this Case Study, Gao et al. present a 59-year-old man with complete staghorn calculi who had previously undergone ileal ureteral replacement. The patient was successfully treated with percutaneous nephrolithotomy. The authors emphasize the essential role of CT urography in diagnosis and treatment planning in such complex cases.
This Case Study describes a 60-year-old woman who presented with an enlarging subcutaneous lesion on her right flank, 6 months after having undergone treatment for transitional cell carcinoma (TCC) of the bladder. The article highlights that rare cutaneous TCC metastases can mimic common benign and inflammatory processes, and the authors suggest treatment options for such patients.
