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Patients with spinal dysraphism can have a large variety of different urological manifestations, thus, effective clinical management of these patients can involve a range of different approaches. Here, authors describe the management of the full range of urological manifestations observed in patients with spinal dysraphism and the future challenges posed by the changing demographics of this patient population.
Interest in multiparametric MRI (mpMRI) for pre-operative prediction of extracapsular extension (ECE) by prostate cancer is growing. As unsuspicious findings on mpMRI cannot rule out ECE, complementary predictors based on clinical and biopsy sample characteristics are needed to risk-stratify patients and plan surgery. Image-guided biopsy might be key in this endeavour.
Most metastatic lymph nodes in patients with prostate cancer go undetected by current imaging techniques and limited pelvic lymph node dissection (PLND), as they are small and located in difficult-to-reach areas. As the only current alternative is an extended PLND, the search for more accurate imaging techniques continues.
Bone metastases in patients with prostate cancer are a primary cause of pain, disability, and death. Body et al. review studies of bone-targeting agents in this setting, as well as the properties of both approved and novel systemic agents with regard to improving skeletal outcomes. They also discuss the place of these agents in the overall therapeutic strategy for patients with metastatic castration-resistant prostate cancer.
Many imaging techniques are currently used for detection of local or distant prostate cancer recurrences after primary treatment. A new retrospective registry study raises concerns about the pertinence of imaging test use after primary prostate cancer treatment. These findings emphasize the need for consensual guidelines on imaging in this setting.
Despite its excellent prognosis, optimal management of stage I seminoma remains controversial, with variations in expert opinion and international guidelines, particularly in terms of uncertainty regarding long-term treatment complications. Recent population-based reports shed new light on the subject, and help clarify the important, unresolved clinical questions that require further research to answer.