Review Articles in 2014

In this Review, Lange et al. give an overview of the main complications associated with commonly used ureteral stents and discuss novel stent designs based on metal or biodegradable materials that could help ameliorate patient discomfort and overcome current problems, such as encrustation and stenosis.

Heat shock proteins (HSPs) are involved in regulation of androgen receptor function, making them targets for therapeutic modulation in the treatment of castration-resistant prostate cancer (CRPC). In this Review, Azad and colleagues discuss HSPs, their roles in CRPC, and the state of current clinical research into HSP blockade.

Extracellular vesicles mediate intercellular signalling and are potential sources of cancer biomarkers. Nawaz and colleagues describe the biogenesis of extracellular vesicles, and the methods available for their isolation and characterization. The authors also discuss current research into the identification of vesicle-derived biomarkers for cancers of the prostate, kidney and bladder.

Delayed diagnosis and treatment of penile cancer often result in the development of advanced disease. Shabbir et al. highlight how pooling resources and expertise can help improve disease management and review remaining challenges in prevention, diagnosis, treatment and lymph node staging.

Detrusor underactivity (DUA) is a poorly understood bladder dysfunction without effective pharmacological treatments. This Review summarizes the available evidence relating to the aetiology and pathophysiology of DUA and highlights the need for further elucidation of the underlying mechanisms to enable the development of new treatment approaches.

Sexually transmitted diseases caused by bacteria, viruses and protozoa can affect the male genital tract. Gimenes and colleagues discuss the evidence for effects of sexually transmitted pathogens on semen, sperm and male infertility.

Treatment of erectile dysfunction by maximizing nitric oxide signalling is not effective for all aetiologies of the condition. In this Review, the authors describe the role of the Rho kinase pathway in erectile dysfunction, its interactions with the nitric oxide pathway and progress towards therapeutic modulation of Rho kinase signalling.

Ureteropelvic junction obstruction (UPJO) is characterized by impaired flow of urine from the renal pelvis to the ureter and if left untreated can significantly impair renal function. Khan and colleagues provide an overview of the diagnosis and surgical treatment of UPJO, proposing optimal management strategies for this common condition.

Song et al. describe the evidence connecting neurotrophins and lower urinary tract function, with particular regard to brain-derived neurotrophic factor, stress urinary incontinence and bladder pain syndrome/interstitial cystitis, and discuss the potential for future therapies based on modulation of neurotrophin levels in the urinary tract and its innervating nerves.

Interstitial cells of Cajal (ICC) were first described in the gastrointestinal tract, however ICC-like cells (ICC-LC) can also be found in the lower urinary tract (LUT), where they act as electrical pacemakers and as intermediary cells involved in the modulation of neurotransmission to adjacent smooth muscle cells. In this Review, Drumm et al. discuss the physiological functions of ICC-LC, focussing on their role as pacemakers, and consider how the study of their intracellular Ca²⁺dynamics will provide a better understanding of the role of ICC-LC in LUT excitability.

In this Review, Fatton and colleagues examine the effects of lower urinary tract symptoms, particularly stress urinary incontinence, on female sexual function. They discuss the clinical tools used to assess sexual dysfunction, and describe sexual function outcomes after surgery for the treatment of stress urinary incontinence.

Autophagy is a beneficial adaptive response to cellular stress, but it can also benefit cancer cells, and can contribute to development of resistance to cancer treatments. The authors describe the complex roles of autophagy and the developments towards modulation of autophagy to improve the effectiveness of prostate cancer therapies.

The multifunctional NUMB protein negatively regulates the NOTCH signalling pathway, which is deregulated in prostate cancer. The authors detail the complex interactions between NUMB and NOTCH, describing the current targets for therapeutic intervention and the potential use of NUMB profiling in patients with prostate cancer.

Cystectomy with urinary diversion is a key approach to the management of bladder cancer. This Review provides an overview of a complication that is common among the men and women who undergo such surgical treatment: sexual dysfunction. In particular, the tools that can be used to assess sexual function in this context and its effect on quality of life, the various contributory aetiological factors underlying sexual dysfunction, as well as approaches to treating sexual issues are discussed.

Detrusor underactivity (DUA) results in prolonged urinary voiding or failure to completely empty the bladder and is associated with lower urinary tract symptoms. Drake and colleagues provide an overview of the pathophysiology and management of DUA, highlighting the aetiological, diagnostic, and therapeutic challenges of this condition.

In this Review, Kauffman and colleagues summarize contemporary understanding of the molecular biology underlyingTFE3 and TFEB gene-fusion-associated (translocation) renal cell carcinomas. They discuss the candidate mechanisms and signalling pathways thought to contribute to the oncogenesis of these tumours, and describe TFE3 and TFEBfusion genetic organization.

In this Review, Smith and colleagues discuss the use of enhanced recovery programmes, which are multimodal approaches to minimize the psychological and physiological disruption—and expedite the return of normal function—after radical cystectomy. They consider the preoperative, perioperative and postoperative factors that should be incorporated into clinical care to improve patient outcomes.

New analyses show that muscle-invasive bladder cancers can be grouped into basal and luminal subtypes that are highly reminiscent of those found in breast cancer. Choi and colleagues introduce the newly identified basal and luminal subtypes of muscle-invasive bladder cancer and explain their implications for the clinical management of this disease.

Testicular torsion is a urological emergency that occurs most commonly in adolescence. In this Review, the authors discuss the pathophysiological mechanisms of testicular torsion and reperfusion injury, before summarizing the large body of preclinical data that exists regarding potential therapies, including antioxidants, hormones, vitamins and plant extracts.

Faure Walker and colleagues review the existing literature on intradiverticular bladder tumours, highlighting the challenges that exist in the management of malignant and premalignant conditions within bladder diverticula. They outline the only guidelines currently available, and provide their own recommendations for the diagnosis and treatment of these conditions.