Urinary incontinence
A population-based study shows that chronic constipation and fecal incontinence are common in patients with overactive bladder (OAB), potentially indicating a shared pathophysiology. In an Internet-based survey of 2,000 participants, both men and women with OAB were significantly more likely than those without this disorder to report chronic constipation and fecal incontinence. These conditions can be considered in the management of OAB.
Imaging
Contrast-enhanced ultrasonography (CEUS) might offer a convenient and radiation-free alternative to retrograde cystourethrography for the evaluation of anastomotic leakage after radical prostatectomy. 43 patients were assessed using both techniques; complete agreement was seen in 31 (72%) cases. CEUS identified no leak in 9 small and 2 moderate cases of extravasation detected by cystourethrography. One small extravasation on cystourethrography was classed as large on CEUS.
Imaging
In men who present with priapism, penile MRI is an accurate means of assessing smooth muscle viability. Among 23 patients with available corpus cavernosum biopsy samples, T2-weighted gadolinium-enhanced MRI was 100% sensitive for prediction of nonviable smooth muscle on histology. In a further 15 patients without biopsy samples, MRI correctly predicted the presence or absence of erectile dysfunction on clinical follow-up.
Kidney cancer
A multi-institutional study has characterized the efficacy of second-line therapy in patients with metastatic renal cell carcinoma who progressed while receiving first-line therapy targeting vascular endothelial growth factor (VEGF). 216 patients received second-line therapy with either anti-VEGF agents, or agents targeting the mammalian target of rapamycin (mTOR) pathway. Overall survival did not differ significantly between the two groups (14.2 versus 10.6 months; P = 0.38), although the time to treatment failure was shorter for those in the mTOR arm (4.9 versus 2.5 months; P = 0.014).
ORIGINAL RESEARCH PAPERS
Coyne, K. S. et al. The prevalence of chronic constipation and faecal incontinence among men and women with symptoms of overactive bladder. BJU Int. doi:10.1111/j.1464-410X.2010.09446.x
Schoeppler, G. M. et al. Detection of urinary leakage after radical retropubic prostatectomy by contrast enhanced ultrasound—do we still need conventional retrograde cystography? BJU Int. doi:10.1111/j.1464-410X.2010.09497.x
Ralph, D. J. et al. The use of high-resolution magnetic resonance imaging in the management of patients presenting with priapism. BJU Int. doi:10.1111/j.1464-410X.2010.09368.x
Vickers, M. M. et al. Clinical outcomes in metastatic renal cell carcinoma patients after failure of initial vascular endothelial growth factor-targeted therapies. Urology doi:10.1016/j.urology.2009.12.031
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In brief. Nat Rev Urol 7, 418 (2010). https://doi.org/10.1038/nrurol.2010.116
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DOI: https://doi.org/10.1038/nrurol.2010.116