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Disparities in prostate cancer treatment patterns have been traced to differences in socioeconomic status. These results have implications for quality of care imparted by health-care providers. Until randomized clinical trials establish standards of care, physicians must be wary of unconscious bias and strive to support, not dictate, the decision-making process.
New research confirms that sacral nerve stimulation is a feasible option for treating subjective symptoms of urinary and fecal incontinence in children. However, owing to a lack of correlation between objective and clinical response parameters, we require standardized means of assessing outcomes in this patient population.
Precise localization of prostate cancer is essential for the success of focal therapies. Despite suggestions that saturation biopsy might be useful in this regard, a new study implies it cannot accurately pinpoint prostate tumors. Research efforts would perhaps be better focused on identifying which patients require treatment for clinically localized prostate cancer in the first place.
Once again the question of one versus two 24 h urine collections for diagnosis in kidney stone prevention has been raised. As in all previous studies, no difference is seen in the mean levels of analytes between first and second collections. However, variation within patients is so marked that at least two collections are needed for confidence.
In 2009, the European Association of Urology published guidelines for the evaluation and management of genitourinary trauma. In this Review, the authors discuss these guideline and provide an overview for clinicians involved in the treatment of patients with renal, ureteral, bladder, urethral and genital trauma.
The PLCO and ERSPC trials have reported the long-term effects on prostate cancer mortality of PSA-based screening approaches; however, a number of controversies remain in this field. Here, Strope and Andriole discuss and interpret the results of these trials, and suggest how PSA-based screening can be improved upon in the future.
Complex interactions between malignant cells and their surrounding environment determine the fate of the evolving tumor. Karlou et al. describe the major pathways implicated in stromal-epithelial crosstalk during prostate carcinogenesis, highlighting the selective inhibitors that are available and are currently being tested as novel therapeutic strategies.
Complex urethral strictures pose a unique challenge for reconstruction and patient satisfaction. This comprehensive Review provides a guide to the management of stricture disease in the settings of previous hypospadias repair, long anterior urethral stricture disease, panurethral stricture disease, recurrent posterior distraction defects, and stricture disease after treatment for prostate cancer.