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The results from two new randomized trials suggest that urodynamic assessment might not be necessary to select patients for stress incontinence surgery. However, whether these findings change clinical practice remains to be seen.
High-intensity focused ultrasound (HIFU) represents a fairly new treatment option for focal therapy of prostate cancer. However, studies evaluating its efficacy have not provided strong data to support the use of HIFU in the majority of patients. Thus, high-profile studies investigating feasibility of the modality in terms of adverse effects seem premature.
New and very expensive forms of radiotherapy, such as intensity-modulated radiation therapy and proton therapy, have taken over the localized prostate cancer market. But is there enough evidence to justify their increased utilization and if so, how can we possibly afford them?
Dysregulation of Wnt signalling, a hallmark of which is the stabilization of the transcriptional co-activator β catenin, can lead to several types of cancer, including prostate cancer. Activation of the Wnt/β catenin pathway has effects on prostate cell proliferation, differentiation and the epithelial–mesenchymal transition. In this Review, the authors discuss how the pathway is activated and consider the possible therapeutic application of drugs that target Wnt/β catenin signalling.
As sling surgery becomes an increasingly popular treatment option for women with stress urinary incontinence (SUI), iatrogenic obstruction and postoperative voiding dysfunction are becoming recognized more and more. In this Review, the authors discuss the incidence, causes, diagnosis, evaluation and treatment of urethral obstruction after sling surgery for SUI.
In this Review, Vaegler and colleagues provide an overview of the use of stem cell therapy for voiding dysfunction and ED. Stem cell sources and isolation techniques are considered, and the authors discuss major clinical studies, as well as preclinical animal studies, that illustrate potential mechanisms of action for this therapeutic approach.
In this Review, Schilling and colleagues explain the key steps of tumour cell dissemination in prostate cancer. Current methods for cell detection are described and the clinical significance of isolated, disseminated and circulating tumor cells with respect to disease prognosis is discussed.
The current diagnostic techniques for prostate cancer (including serum PSA level measurement) lack sufficient specificity and sensitivity to determine the aggressiveness of the disease and to identify appropriate treatment. Thus, additional biomarkers are needed that can facilitate early diagnosis, determine the patient's prognosis and predict responses to a given therapeutic intervention. In this Perspectives article, the authors argue that patented biomarkers are the closest to market and can be used to assess progress in this field.
