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Urologic cancers during pregnancy are rare, but pose an important clinical challenge. Makarand Khochikar discusses the diagnosis and treatment of these cancers, which often present with symptoms that mimic common pregnancy-related disorders. Appropriate treatment is imperative, and depends on the type of cancer and the stage of pregnancy at which it is detected.
Men with spinal cord injury (SCI) have severely impaired fertility, characterized by erectile dysfunction, ejaculatory dysfunction, and semen abnormalities. In this Review, authors from the US and Denmark discuss the treatment of these patients, the latest research into semen abnormalities, and the management of infertile couples in which the male partner has SCI.
Since its inception in 1966, the Gleason system for the grading of prostate cancer has evolved to keep pace with changing practice in both pathology and urology. Here, Lotan and Epstein discuss the changes to the definition of pattern 3 and 4 disease, and highlight the impact of these modifications on research and clinical practice.
Obesity is associated with an increased incidence of male factor infertility. By synthesizing new and old data, the authors of this Review offer a completely novel perspective on the relationship between high BMI, disordered spermatogenesis, and fertility problems. Potential mechanisms and available treatment options are succinctly discussed.
Treatment aimed at restoring the underlying tissue and vascular defects that cause erectile dysfunction is sorely lacking. Harraz et al. describe recent advances in the use of gene therapy to improve penile function, highlighting the potential therapeutic benefits. The current status of stem cell research in this area is also discussed.
The etiology and pathogenesis of CP/CPPS remain unknown, but it is becoming clear that neuropathic pain plays an important role. Here, Strauss and Dimitrakov discuss emerging treatments that are known to target pain pathways, and explore the implications of these treatments with respect to unraveling the etiology of CP/CPPS.
In this Review, the authors discuss the potential of testicular germline stem cells as a substrate for cell-based therapies. Although at an early stage, research in this field is progressing rapidly. If their promise is fulfilled, such cells could be applied to a range of therapeutic indications, including tissue reconstruction and fertility restoration.
Current imaging modalities lack sufficient sensitivity and specificity for the noninvasive staging of lymph nodes in genitourinary cancers. In this Review, Mouli and colleagues from Northwestern University discuss the potential role of lymphotropic nanoparticles—which selectively accumulate in benign lymph nodes—in enhancing the MRI detection of nodal metastases.
The targeting of angiogenesis is a growing area of cancer therapy.In vivo imaging techniques allow the noninvasive evaluation of changes in tumor vasculature in response to antiangiogenic agents. Zee et al. provide an overview of MRI, CT, PET and ultrasound techniques, highlighting their application in renal, prostate and bladder cancer.
The publication last year of large trials of PSA screening in prostate cancer has rekindled interest in alternative noninvasive markers for this disease. Here, Ploussard and de la Taille discuss the range of potential urinary biomarkers in prostate cancer, and the current clinical data on their utility in disease detection and staging.
The capacity of traditional noninvasive diagnostic procedures such as microhematuria testing and urine cytology to be used as stand-alone screening techniques for urothelial carcinoma is limited. New qualitative and quantitative molecular screening modalities can detect alterations that are often exclusively associated with this disease. Mitra and Cote propose incoporating both traditional approaches and molecular tests into a risk-based screening strategy.
Multimodal treatment utilizing combined androgen suppression and radiotherapy has improved survival rates for patients with high-risk prostate cancer. Rosenthal and Sandler provide a timely summary of the clinical trials that have been carried out in this area, as well as discussing recent advances in dose-escalated radiotherapy and adjuvant chemotherapy.
