Reviews & Analysis

Despite being used in practice for around 30 years, the safety of assisted reproductive technologies is still questioned. Studies are hampered by issues related to trial design and consistency of reporting. Some long-term data are, however, now available for offspring conceived after assistance by a variety of technologies. This Review aims to summarize the reported risks.

In this Case Study, Phipps et al. describe a 33-year-old woman with severe hypertension resulting from iatrogenic ureteric injury. The authors discuss the underlying mechanisms of hypertension caused by ureteric obstruction, and they use the case to illustrate the effective endourological management of short, completely obliterating, distal ureteric strictures.

Balkan endemic nephropathy is a familial disorder that affects people living in the alluvial plains along the tributaries of the Danube River and has a strong association with upper urothelial carcinomas. Although thought to be declining in incidence, it still represents a notable problem and these authors suggest it might be more widespread than previously thought.

The use of nomograms for predicting tumor characteristics and outcomes in prostate cancer patients can be helpful in treatment decision-making. In this article the authors review several nomograms, developed since the observed stage migration in prostate cancer, that can be used to predict cancer prevalence at prostate biopsy, prognosis and pretreatment staging.

Ejaculatory dysfunction is a common and distressing problem for many men, which can adversely affect their personal relationships and quality of life. In this Review the authors discuss the physiopathological, diagnostic, and therapeutic aspects of disorders of ejaculation focusing on premature ejaculation, the most prevalent of these disorders.

Advances in assisted reproductive technologies have led to declining use of therapeutic donor insemination by urologists treating male factor infertility. Insemination by this technique is, however, still appropriate for a notable number of couples trying to conceive. This Review discusses the indications and the related outcomes, costs and psychosocial issues.

Primary lymphoma of the bladder is a rare condition, typically presenting as intermittent hematuria, urinary frequency and dysuria. In this Case Study, Horasanli et al. report the management, using transurethral resection, chemotherapy and radiotherapy, of a 65-year-old woman who presented with urinary symptoms and a right hydronephrosis resulting from this tumor.

This article is the first of two Viewpoints on the treatment of detrusor overactivity. The authors of this article advocate the use of sacral nerve modulation for this indication, and they describe the advantages of sacral nerve modulation compared with botulinum neurotoxin.

In this second Viewpoint on the treatment of detrusor overactivity, the authors describe the preclinical and clinical data that support the use of botulinum neurotoxin in patients with detrusor overactivity, and highlight the benefits of botulinum neurotoxin over the use of sacral nerve modulation.

In this Case Study, Tu et al. report on a 61-year-old man previously treated for prostatic adenocarcinoma who presented with obstructive urinary symptoms and was subsequently found to have ductal carcinoma of the prostate. The authors discuss the difficulty of diagnosing this tumor, and the correct approach to its management.

Large renal tumors of 7 cm or more in size are associated with important challenges in management. In this Review the authors discuss the different surgical management options for patients with these large tumors. Important complicating factors such as tumor thrombus are discussed and the authors also examine the use of partial nephrectomy in patients with T2 renal tumors.

The process of learning surgical skills is long, complex and involves numerous stages. The authors of this Review discuss the different processes involved in learning and assessing surgical techniques. They highlight the role of surgical simulators in training surgeons in new techniques and how they might help to improve trainee surgeons' performance and patient outcomes.

Androgen deprivation therapy (ADT) for prostate cancer is associated with decreased bone mineral density (BMD) in patients. This decreased BMD can lead to an increased risk of fractures and osteoporosis. In this article the author reviews the prevalence of bone loss in this group of patients, and discusses the implications of reduced BMD and what can be done to prevent or reduce bone loss in men undergoing ADT.