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A repeat biopsy procedure is performed in patients with suspicion of prostate cancer after initial biopsy. However, the optimal strategy for repeat biopsy is not known. A new study now elucidates the ideal number and location of cores according to each patient's tumor characteristics. Further validation will be required.
Accurate prediction of Gleason grade before treatment begins is crucially important in decision-making because it is a predictor of prostate cancer aggressiveness. A recent study has reported that biopsies targeted towards the most abnormal regions on 3T diffusion-weighted imaging could improve the accuracy of the assessment of true tumor aggressiveness.
Warm ischemia time during partial nephrectomy is an important risk factor for renal failure after surgery. A new study proposes using anatomic vascular microdissection of renal artery branches to perform zero-ischemia partial nephrectomy. Although the results are promising, the technique is challenging and requires further evaluation.
Urinary incontinence is a common condition among older adults. Numerous clinical guidelines have been published with recommendations for incontinence evaluation and management, especially in women. However, practitioner adherence to guidelines is often poor, particularly for elderly patients. What influences this trend? Is it a form of ageism in health care?
Systemic inflammation has been linked with cancer development and progression. C reactive protein (CRP) is a useful marker of systemic inflammation. CRP levels could predict survival in patients with urological cancers, and the incorporation of CRP into prognostic models improves the models' predictive accuracy. The analysis of CRP kinetics could predict tumor aggressiveness and response to treatment. In this Review, Saito and Kihara discuss the usefulness of CRP as a prognostic biomarker in urological cancers, including renal cell carcinoma, bladder cancer and prostate cancer.
Radical cystectomy with subsequent urinary diversion has been assessed the most difficult surgical procedure in the field of urology. In this Review, the authors discuss the need for standardized reporting of complications after urinary diversion, and summarize our current knowledge of the complications associated with different diversion techniques.
Genitourinary tuberculosis (GUTB) is the second most common form of extrapulmonary TB, with more than 90% of cases occurring in developing countries. In this Review, Abbara and Davidson present the epidemiology and pathophysiology of TB and describe the diagnostic tests and imaging techniques. They also elucidate the sites of GUTB in men and women and explain the treatment options. Future challenges for the management of drug-resistant patients and those with HIV co-infections are also considered.
Wnt signaling is thought to have an important role in the development of several human cancers, but its role in renal cell carcinoma (RCC) seems to be distinct from other cancer types. In this Review, the authors describe our current understanding of Wnt signaling and the action of several endogenous Wnt antagonists in the context of RCC, and discuss how study of these proteins might lead to the development of effective new targeted therapies for patients with this malignancy.
