Articles in 2014

The EAU has issued the first clinical practice guidelines on priapism, which have been published in short form in European Urology. Put together by the EAU panel on male sexual dysfunction, these guidelines provide an accessible, structured guide for the diagnosis and treatment of this rare clinical disorder.

Implementing a well-structured laparoscopic training curriculum during urology residency has proven to be challenging. The results of the European Training in Basic Laparoscopic Urological Skills (E-BLUS) examination show low levels of proficiency in laparoscopic techniques for urology residents completing training. What must be done to improve these standards?

In the past two decades, improvements to the techniques of radical hysterectomy and chemoradiotherapy for the treatment of cervical cancer have led to a reduction in the associated urological complications. This Review considers the prevalence of lower urinary tract dysfunction in the era of nerve-sparing surgery and decreased radiation fields.

In response to the demand for reconstructive options that preserve quality of life after cystectomy, 2013 saw considerable advances in biocompatible meshes and stem cell preparations that might recapitulate the urinary bladder. With increasing strength and functionality of these substitutes, what challenges remain?

Few series have reported on the incidence of lymph node metastases, multimodal treatment, and long-term outcomes associated with extended pelvic lymph node dissection in large cohorts of patients with surgically treated prostate cancer. The first nomograms for predicting prognosis from such data have only recently been developed and internally validated.

BPH is one of the most common lower urinary tract diseases that predominantly affects men of advanced age. This Timeline article highlights the pivotal advances in BPH treatment (surgical and medical) from the late 19th century to the present day.

In 2013, data began to emerge that shed light on several longstanding issues in female urology, from the safety of adrenergic receptor agonists and onabotulinumtoxinA for overactive bladder to the use of physical therapy and mesh suburethral slings for stress urinary incontinence.

Considerable developments in prostate cancer in 2013 have emerged from the imaging field. Hyperpolarized ¹³C-MRI can monitor metabolic activity to identify high-grade disease and treatment response, and novel PET radiotracers might identify distinct subsets of patients with advanced disease. These examples highlight the progress made at all stages of care.

In this Review, Wagenlehneret al. discuss strategies to reduce rates of severe symptomatic infection and urosepsis after prostate biopsy, such as preoperative assessment (including history of fluoroquinolone intake over the past 6 months), urine culture, targeted antibiotic prophylaxis after sampling of the rectal flora, bowel preparation, and perineal prostate biopsy.

Erectile dysfunction (ED) is often overlooked in men with HIV, despite its high prevalence in affected men of all ages. In this Review, Santi and colleagues discuss the aetiology and social issues associated with ED in men with HIV, and provide useful advice for the clinician treating such patients.