Review Articles in 2010

Modification of dietary and lifestyle factors might have an important role in both the primary prevention and treatment of prostate cancer. Here, Venkateswaran and Klotz outline the mechanisms by which dietary factors affect prostate cancer, and discuss how this knowledge might be used to design chemopreventive protocols for this disease.

Urinary tract infections are experienced by a large section of the population and cause significant morbidity. Here, Nielubowicz and Mobley explain the pathogenic mechanisms utilized byEscherichia coli and Proteus mirabilisduring complicated and uncomplicated infection, respectively. They outline the strategies currently underway to exploit these processes for the identification of new treatment options.

Improving the end-of-life care for patients and their families has become an increasingly high priority for the UK National Health Service over the past decade. This Review describes several government initiatives, such as the National End of Life Care Programme, and, using a case history of a patient with terminal prostate cancer, how they have been implemented at a local level.

Today's urologists require a broad skill set, and training must keep pace with scientific and technical advances in a number of fields. Here, Ahmed and colleagues discuss the issues surrounding competency in this specialty, focusing on the attributes required of a competent urologist, and the tools and frameworks used to evaluate and improve these skills.

Hydrocele in patients aged 13–18 years are mostly likely idiopathic in origin or caused by varicocelectomy. Cimador and colleagues describe the clinical presentation and diagnosis of hydrocele in adolescents, before discussing the possible treatment options for these individuals.

Management of urethral strictures can be challenging, given the heterogeneity of the disease and the myriad surgical techniques from which to choose. In this Review, Drs. Zimmerman and Santucci describe three urethroplasty procedures—anastomotic, buccal mucosal graft-onlay and the two-staged Johanson urethroplasty—that can accommodate the majority of patients and give good long-term results.

Achievement of urinary continence is an important developmental step, but debate continues as to the best age to begin toilet training. This Review by Professor Wu focuses on the achievement of urinary continence in children, discussing the optimum age for toilet training and providing an overview of bladder function and voiding mechanisms in the infant and young child. Medical disorders that may cause difficulty in achieving urinary continence are also overviewed.

Identification of xenotropic murine leukemia virus-related virus (XMRV) in patients with prostate cancer or chronic fatigue syndrome has spurred a flurry of research activity. Different research groups have had dramatically disparate results. In this Review, Robert Silverman and colleagues address the many questions, issues and controversies that require resolution.

The increasing incidence of renal cell carcinoma can be attributed in part to the growing use of abdominal imaging leading to more frequent incidental discovery of small renal masses. Here, the authors compare the advantages and limitations of several techniques for the evaluation of renal masses, as well as their roles in disease staging and surveillance.

The advent of targeted therapies transformed the treatment of metastatic RCC. Sun et al. provide a comprehensive summary of the published evidence for the efficacy of immunotherapy, cytoreductive nephrectomy and targeted therapies in treating this disease. They highlight sequential approaches and offer clinical recommendations for the contemporary patient.

The immunologic microenvironments of renal allograft rejection and renal cell carcinoma (RCC) share a number of similarities, although the resulting immune responses are markedly different. This Review discusses the cellular and molecular mechanisms underlying allograft rejection and RCC immune evasion, and how immunotherapy might be used to induce tumor rejection.

PET–CT allows simultaneous capture and co-registration of functional and anatomical data. Here, Australian-based authors outline the current clinical status of this 'functional imaging' in renal cell carcinoma. New radiotracers and approaches—including radiolabeled monoclonal antibodies and imaging of tumor hypoxia—are touched on, and areas of future research discussed.

In this Review, Bratslavsky and Linehan address the management of the challenging group of patients with bilateral, multifocal, recurrent renal cell carcinoma. They discuss the treatment options and outcomes for these patients, highlight the importance of maximal renal preservation, and outline a management strategy developed from their own experience in treating these patients.

Overall kidney cancer incidence shows signs of stabilizing, or even decreasing worldwide, except in the US, where renal cell carcinoma incidence continues to rise. This Review by Chow and colleagues discusses the descriptive incidence and changing prevalence of risk factor patterns of adult kidney carcinoma, both internationally and in the US.

The prolonged survival of patients with HIV as a result of improved medical therapies, such as highly active antiretroviral therapy, has led to an increased number of these patients developing non-AIDS-defining malignancies, including prostate cancer. The management of HIV-positive patients with prostate cancer is discussed in this Review.

Over the past decade, research interest in the functional and regulatory roles of microRNAs, a class of small, non-coding RNAs, has increased dramatically. In this article, the authors provide an overview of the role of microRNAs in urologic tumors, and highlight their potential as diagnostic or prognostic markers of disease and as targets for cancer treatments.

Stress urinary incontinence affects most men who undergo radical prostatectomy. This dysfunction will spontaneously resolve within 12 months for most patients—exercising the pelvic floor has been shown to hasten recovery. There are a number of surgical options for men in whom the condition persists.

In this Review, authors from Stanford University discuss the differences between children and adults in the presentation and diagnosis of atraumatic, asymptomatic hematuria. In adults, evaluation focuses on distinguishing benign from malignant etiology. In children, by contrast, evaluation should focus on glomerular versus non-glomerular causes.

Pharmacological treatments for Peyronie's disease generally have limited success. Research using cell culture systems and animal models has provided insights into the fibrotic mechanisms underlying this disease, and has revealed a novel and potentially effective application of phosphodiesterase 5 inhibitors in this context.

Late radiation cystitis affects up to 10% of patients who receive radiotherapy for a tumor in the pelvic region. Shaun Smit and Chris Heyns discuss the available management strategies for those with this potentially life-threatening complication, including intravesical and systemic therapies, surgical interventions and hyperbaric oxygen treatment.