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The authors of a recent study propose to expand the criteria for “good surgical outcome” for robot-assisted laparoscopic radical prostatectomy (RARP), a relatively new procedure. Without level 1 evidence to support such clinical innovations, it is vital that surgeons adopt critical self-appraisal in order to improve the reporting of outcomes.
A large, randomized, phase III study has shown that denosumab, a monoclonal antibody targeting RANK ligand, is more effective than zoledronic acid for preventing skeletal morbidity in castration-resistant prostate cancer. Although denosumab is convenient to administer and well tolerated, its use is likely to be limited by economic considerations.
Bladder management is an important aspect of the management of patients with spinal cord injury (SCI). A device capable of performing ambulatory urodynamics on individuals with SCI has recently been developed; however, the benefit of ambulatory urodynamics in patients with SCI is disputed.
Over the last decade, NMR technology has become indispensible in the diagnosis and characterization of prostate cancer. In this Review, the authors discuss the evolution of NMR in prostate cancer, from its humble beginnings, up to today's use of NMR metabolomics.
Active surveillance is now an accepted management strategy for men with low-risk localized prostate cancer. Here, Lawrentschuk and Klotz provide an overview of the current issues concerning this somewhat contentious regime, including how best to select patients for active surveillance, which criteria should prompt intervention, and the concept of secondary chemoprevention.
The clear-cell variant is the most common subtype of renal cell carcinoma (RCC) and, as discussed in this Review, accurate diagnosis of clear cell RCC is important and can be a challenge. Valera and Merino describe the clinical, pathological, and radiological features of clear cell RCC as well as the factors important to prevent misdiagnosis of this disease.
In some men, increased age is associated with a reduction in testosterone, with a range of sexual, physical and psychological symptoms. Although this syndrome is referred to by many names, late-onset hypogonadism (LOH) is the most scientifically accurate. In this Review, Huhtaniemi and Forti summarize the pathophysiology, diagnostic criteria and treatment options for LOH, and discuss the controversies that surround the LOH diagnosis and the use of androgen replacement therapy.
Controlled tissue cooling has been used therapeutically for decades to mitigate the negative effects of traumatic, ischemic, and surgical insults. Finley proposes that since recovery of urinary continence and erectile function is improved when localized hypothermia is used during radical prostatectomy, similar benefits might be observed for other types of radical pelvic surgery.
