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The average age of men diagnosed with prostate cancer is falling, and thus the burden of morbidity associated with its treatment is of great interest. Physicians want to provide their patients with definitive cancer treatment, but without the morbidity which is associated with surgery and radiotherapy. Ablative therapy, using modalities such as high-frequency focused ultrasound (HIFU), offers an exciting prospect for in situ definitive treatment of prostate cancer, with a theoretical reduction in associated adverse effects.
Blue-light cystoscopy is a method of photodynamic diagnosis (PDD) used in the bladder which offers an opportunity to improve the quality of the endoscopic diagnosis and treatment of bladder cancer by enhancing the color contrast between tumor and non-tumor tissue. Introduced in Germany1 nearly 20 years ago, a substantial body of evidence, including a recent paper by Geavlete et al.,2 suggests that PDD markedly improves the completeness of the initial resection in transurethral endoscopic surgery.
Late-onset hypogonadism (LOH) is frequently difficult to diagnose in middle-aged and elderly men. A recent study has reported that a cluster of three sexual symptoms and a total testosterone threshold of less than 11 nmol/l are important determinants for the diagnosis of LOH in this age group.
While the phosphodiesterase 5 (PDE5) inhibitors sildenafil, vardenafil and tadalafil have transformed the treatment of men with erectile dysfunction, a number of new PDE5 inhibitors have become available in the Far East. In this Review, the authors describe the efficacy of these new drugs, and briefly review the current state of development of other pharmacological therapies for erectile dysfunction, such as gene therapy and stem cell therapy.
Serum tumor markers play a more critical role in testicular germ cell tumor management than in any other solid organ malignancy. Here, Barlow and colleagues discuss how the serum levels of AFP, hCG and LDH provide essential information for the differential diagnosis, staging, risk-stratification and surveillance of testicular tumors.
Renal pseudoaneurysm is a rare but serious complication of renal trauma and of a number of medical procedures. In this Review, the authors provide an introduction to the subject of renal pseudoaneurysm, and discuss the diagnosis and options for treatment of this potentially life-threatening condition.
Pelvic reconstructive surgery with concomitant hysterectomy is the standard of care for pelvic organ prolapse, even though many women would prefer to preserve their uterus and vaginal function. Zucchi et al. describe uterus-sparing procedures that have been reported, and discuss the complication rates, anatomical success rates and functional outcomes of each.
In this Case Study, the authors describe a patient with metastatic renal cell carcinoma who was treated with neoadjuvant sunitinib before cytoreductive nephrectomy. Despite a good clinical response to therapy, the patient experienced progression of an unidentified spinal metastasis during the preoperative drug vacation.
The ShangRing is a novel device which has the potential to be used for safe and effective circumcision in areas where good surgical facilities and surgically trained personnel are scarce; and where HIV is widespread. In this Perspectives, the authors discuss the available data on the ShangRing and consider the possibilities for its future use in resource-poor areas.
