Volume 9 Issue 2, February 2012

2011 was a breakthrough year for the treatment of castration-resistant prostate cancer. The encouraging results of two large clinical trials were reported, as well as data identifying a number of promising new therapeutic targets. Bone-modulating agents continued to show potential for the prevention of skeletal events.

Long awaited data from the clinical investigation of bladder cancer in both the neoadjuvant and adjuvant settings were released in 2011, setting the stage for the next generation of work in this area. The findings of a number of studies provide the first steps towards a personalized approach to this disease.

Research into sexual dysfunction is expanding rapidly; in 2011 alone more than 600 articles on sexual dysfunction were listed in PubMed. Increased understanding of pathophysiology, epidemiology, clinical diagnosis and therapeutic options has propelled clinicians and researchers alike to be more innovative and holistic in their approach to the management of sexual dysfunction.

The past year has seen several new developments in the field of male reproductive health, including a major revision of how urologists should assess semen quality following the release of new WHO guidelines, novel approaches to sperm selection for intracytoplasmic sperm injection, and changes in how clinicians might evaluate and treat patients with hematospermia.

Contemporary treatment guidelines for the localized renal mass are largely driven by expert opinion and retrospective observational data. Three articles published in 2011 add important information to the existing body of literature, enabling improved objectification of risk and individualization of clinical tradeoff decisions for patients presenting with localized renal tumors.

The expanding availability of multiple therapeutic strategies and sequencing options for renal cell carcinoma (RCC) has increased the importance of skilled individualized outcome estimation for patients. In this Review, the authors examine a number of the available statistical models for the management of patients with RCC and highlight those most likely to be of use in a busy clinical setting.

Asymptomatic bacteriuria (ABU) is defined by the presence of bacteria in the urine of a patient without signs or symptoms related to UTI. A common condition that is often treated unnecessarily with antibiotics, ABU should be detected and treated in pregnant women and patients undergoing urologic surgery, but in most other patient groups, treatment does not confer benefit and can be harmful. In this Review, Trautner discusses the science behind ABU, when it should be treated, and what is being done to change the prescribing behavior of physicians managing a patient with ABU.

A combined DW-MRI and T2W-MRI approach has been associated with improved accuracy for prostate tumor detection and has been suggested as a tool to guide tissue biopsy. DW-MRI can be used to gather tumor-related information in a noninvasive manner and has potential further roles in active surveillance, evaluating treatment efficacy, and predicting disease recurrence. Validation in large prospective multicenter trials is critical if this technique is to be integrated into current management algorithms for prostate cancer.

Aspirin is associated with a reduced risk of colorectal cancer, which has led to the suggestion of a similar protective role in urological cancers. Bosetti et al. have examined all the available epidemiological data to assess if a relationship exists between aspirin use and cancers of the prostate, bladder and kidney.

XMRV was identified in samples isolated from prostate cancer tissues in 2006, but has since been shown to have arisen from the genetic recombination of two viral genomes carried in the germ-line DNA of mice. Here, Sfanos et al. chart the rise and fall of XMRV from its initial detection in 2006, via claims of its role in prostate cancer, to the 2011 report of its recombinant origin, and explain why they believe XMRV has no role in prostate cancer pathogenesis.