Review Articles in 2005

Gonadotropin-releasing hormone (GnRH) agonists are commonly used to treat men with prostate cancer. The hypogonadal state induced by GnRH agonists can lead to increased bone loss and, ultimately, osteoporosis in many men. This review outlines the mechanisms involved in bone loss associated with GnRH agonists and discusses the different measures that can be utilized in the treatment and prevention of osteoporosis in this group of patients.

In order to understand the mechanisms behind abnormal gonadal development it is important to understand the process of normal development. In this review, the normal development of the gonad in mammals, and the molecular pathways and candidate genes that have been implicated in abnormal gonadal development, are discussed.

The process of angiogenesis is central to the development and spread of cancer. Modern imaging techniques are increasingly offering ways in which the markers of angiogenesis can be visualized. This article discusses the different imaging methods that can be used to assess angiogenesis in the prostate gland.

In this article by André Naudé and Chris Heyns the controversial issue of management of urethral strictures is tackled. The authors review the relative efficacy and suitability of internal urethrotomy, dilation and urethroplasty for treatment of different types of stricture. An algorithm for the initial management of strictures and treatment of recurrent strictures is included.

There is growing evidence that interstitial cells play a functional role in the urinary tract. This review by Alison Brading and Karen McCloskey focuses on what is known about specialized interstitial cells, their underlying physiology and their possible roles in regulating smooth-muscle activity and neural control in the urinary tract. The involvement of these cells in bladder pathology is also discussed.

When seeking a diagnosis in patients complaining of lower urinary tract symptoms there is a bewildering variety of questionnaires, symptom scales, measurements and urodynamic tests that can be utilized. The appropriate use of these different diagnostic tools and their associated strengths and weaknesses are discussed in this primer review by Christopher Chapple.

There is much debate surrounding the suitability and utility of different prognostic markers in prostate cancer. PSA doubling time (PSADT) has become an important marker in predicting the response to salvage radiotherapy and progression to metastatic disease in men with biochemical failure following local therapy. The methods of calculating PSADT and its use as a prognostic marker are discussed in this review by James Eastham.

There are a number of factors that can influence a person's risk of developing cancer. In this review focussing on transitional cell carcinoma of the bladder, Erika Wolff and colleagues discuss the genes and molecular pathways implicated in the development of bladder cancer. Models for both the mechanisms behind bladder carcinogenesis and its progression are presented.

Multiple sclerosis (MS) is commonly associated with a number of lower urinary tract symptoms (LUTS), the type and severity of which vary with regard to the gender of the patient and the severity of their MS. In their article, Vinay Kalsi and Clare Fowler review the neurologic control of bladder function and the different treatments available to patients with MS who experience LUTS. Unlicensed and possible future treatments are also discussed.

In this review, Renata Huzjan and colleagues discuss the utility of MRI and magnetic resonance spectroscopic imaging (MRSI) in the diagnosis and management of prostate cancer. MRI and MRSI provide important information on the extent, location and characteristics of tumors that is invaluable in pretreatment decision making. In order to fully exploit these techniques, a multidisciplinary approach is essential.

Priapism, particularly ischemic priapism, is uncommon in the general male population, but frequently occurs in men with hematologic dyscrasias such as sickle cell disease. In this review, Arthur Burnett focuses on the management of ischemic priapism, and stresses the need for prompt treatment in order to preserve erectile function in this group of men.

Premature ejaculation (PE) has a number of known causes, and the definition of what constitutes PE can differ. Several factors are used to assess the presence and extent of PE. Chris McMahon discusses the etiology and management of PE, and highlights the importance of selecting treatments that are appropriate to the cause of the condition

A number of different surgical techniques are used for the treatment of benign prostatic hyperplasia(BPH). This article by Liam Wilson and Peter Gilling reviews the different types of lasers available and their applications in ablation, coagulation and enucleation of the hyperplastic prostate for treating BPH.

Penile reconstructive surgery requires expertise in genital surgery, whether it is for traumatic injuries or penile cancer. The stages of initial assessment and management of traumatic penile injuries and penile cancer, and the different reconstructive techniques available, are described in this review by David Ralph and colleagues.

Developments in endourologic procedures now mean that the majority of patients with upper tract transitional cell carcinoma (UTTCC) can be offered minimally invasive treatments. Michael Ost and colleagues review the different procedures and adjuvant treatments available, and their suitability for patients with UTTCC.

The incidental finding of small renal masses is becoming a more common event as a result of widely used cross-sectional imaging techniques. This review by Alessandro Volpe and Michael Jewett discusses the risks of tumor progression, techniques for assessing tumors and the different management options available to patients with renal cell carcinoma.

Retroperitoneal lymph node dissection (RPLND) is used in both the staging and management of non-seminomatous germ-cell tumors. Although a number of advantages of the laparoscopic approach have been reported over open RPLND, its use has not been supported by formal internal review board-approved studies. Brett Carver and Joel Sheinfeld discuss RPLND in the management of these tumors, both before and after chemotherapy.

Invasive urologic procedures carry the potential to cause hemorrhaging, the risk of which is greater for patients receiving long-term anticoagulation therapy. Paul Daniels reviews these risks and the management options that can be used to balance the risks of hemorrhage against the problems of venous thromboembolism, if anticoagulation therapy is stopped in this group of patients.

In this review, Fiona Burkhard and colleagues discuss the use of retroperitoneal lymph node dissection in both the staging and treatment of prostate cancer. Their discussion covers the preoperative methods used to assess lymph nodes and compares the merits and drawbacks of extended compared to limited lymphadenectomy when staging prostate cancer, and their possible influence on patient survival.

Hitherto-neglected investigation of processes that underlie the characteristic feature of Peyronie's disease—deposition of fibrotic plaques in the penile tunica albuginea—has been kick-started by the recent development of two rat models. This update of new data is framed around the hypothesis that Peyronie's plaques are a product of perturbed interplay between profibrotic and antifibrotic factors, induced by trauma.