Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
Although various male sling techniques are available, artificial urinary sphincter surgery (AUS) remains the treatment of choice for male stress urinary incontinence. A recent article has described the surgical learning curve for reoperation rates after AUS implantation, finding that there was no plateau, even with very experienced surgeons.
A multicenter randomized trial comparing a trocar-guided mesh kit to anterior colporrhaphy for treatment of cystocele adds to evidence that transvaginal mesh for treatment of anterior vaginal prolapse improves anatomical outcomes at the expense of greater complications. Careful consideration of benefits and risks is required when considering transvaginal mesh for prolapse repair.
Radiation exposure is inevitable when using fluoroscopy for ureteroscopic procedures. However, there are numerous acute adverse effects of radiation, and the long-term effects are unclear. Thus, efforts to minimize the use and duration of fluoroscopy are essential for the benefit of not only the patients, but also the surgeons carrying out the procedure.
The European Organisation for Research and Treatment of Cancer (EORTC) tables estimate risks of tumor recurrence and progression in patients following transurethral resection of non-muscle-invasive bladder cancer. But how well do the predictive accuracy and discriminative ability of the tables stand up in patients administered bacillus Calmette–Guérin (BCG)?
The metabolic syndrome comprises a number of disorders which predispose to cardiovascular disease, and is associated with a Western lifestyle. Urological diseases are emerging as possible constituents of the metabolic syndrome. In this Review, the authors discuss the evidence supporting the inclusion of urological diseases as part of the metabolic syndrome and consider the clinical implications of such data.
Overactive bladder (OAB) is a challenging clinical condition and treatment can include behavioral therapy or antimuscarinic agents. A placebo effect has been reported in randomized controlled studies of antimuscarinic agents for OAB. In this Review, Mangera and colleagues assess the response to placebo in OAB and describe a positive placebo effect in OAB outcome parameters. Reasons for the placebo effect and its potential use will also be discussed.
Contemporary increase in the prescription of anticoagulant and antiplatelet drugs can increase the risk of TURP-related bleeding. Kavanagh et al. describe the commonly-prescribed prohemorrhagic medications that clinicians should be familiar with and discuss when it is safe to withhold them. They also discuss the medications and surgical techniques that can be used to minimize prostatic blood loss.
There is a need for new molecular markers to aid histopathological assessment in upper urinary tract urothelial carcinoma (UUT-UC). p53 is the most extensively investigated marker in this disease; however, the data is inconclusive. In this Review, the authors critically discuss the studies investigating p53 expression in UUT-UC, and consider whether there is any potential clinical application of this biomarker.
Partial nephrectomy is associated with ischemia–reperfusion injury caused by vascular clamping. However, ischemia is not a vital part of the procedure, and nonclamping surgery can be carried out. In this Perspectives, the authors review the evidence regarding clamping and nonclamping partial nephrectomy, and discuss their own surgical experiences with these techniques.
