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Accurate selection of patients with low-risk prostate cancer for active surveillance relies upon conventional clinical staging and grading criteria. New approaches in imaging as well as novel serum-, urine- and tissue-based biomarkers have been developed to reduce initial misclassification and predict risk of disease progression.
Transient receptor potential (TRP) channels have an important role in sensory mechanisms of the lower urinary tract. Vanneste et al. discuss the involvement of TRP channels in normal and abnormal bladder sensations and their potential as therapeutic targets.
The value of proton therapy in managing prostate cancer is not yet defined. A recent study has reported promising long-term results for patients with localized prostate cancer who received proton therapy. However, results from ongoing clinical trials are required before determining the role of proton therapy for this indication.
Adiposity and skeletal muscle mass have been shown to be prognostic for mortality in several cancers. In a recent study, CT imaging at diagnosis was used to determine whether components of body composition were associated with survival in men with advanced prostate cancer.
Premature ejaculation is thought to affect up to one-third of men, but a considerable proportion of patients do not meet the diagnostic criteria and do not, therefore, receive treatment for their symptoms. In this Perspectives article, the authors propose a new taxonomy for premature ejaculation, to encompass the subclinical disorder and its co-occurrence with erectile dysfunction, with a view to improving patient management.
MRI has become an established tool in the diagnosis, management and treatment of localized prostate cancer. However, standardized guidelines on reporting prostate MRI have not yet been developed. A recent consensus study proposes a certification framework for reporting prostate MRI in the UK.
Rare genitourinary cancers have historically been challenging to treat given the scarcity in incidence, inadequacy of data on treatment and lack of general consensus to guide routine therapy. A phase II multicentre trial shows efficacy of nivolumab and ipilimumab in several cohorts of patients with rare genitourinary cancers.
Many patients with muscle-invasive bladder cancer are currently excluded from cisplatin-based neoadjuvant chemotherapy owing to renal impairment. Here, Jiang and colleagues present an update on cisplatin-induced nephrotoxicity in muscle-invasive bladder cancer and highlight a multidisciplinary and patient-centred approach to treatment decision-making.
Surgical ergonomics in urology has been understudied and underemphasized. This Review characterizes the burden of musculoskeletal injury in urologists and focuses on various ergonomic considerations relevant to the urology surgeon.
A new study reports that selected patients with short life expectancy can safely undergo partial nephrectomy with perioperative outcomes that approximate those of patients with long life expectancy. The authors suggest that extensive centre and/or surgeon experience, a robot-assisted approach, and off-clamp and simple enucleation techniques might facilitate favourable outcomes in these challenging patients.
