Reviews & Analysis

Urinary tract stones and urinary tract infection are strongly associated. In this Review, Thomas and Tolley describe the pathogenesis, diagnosis and management of infection stones, and also the management of patients who develop infections as a consequence of stone disease.

The integration of molecular biomarkers into prediction models has the potential to improve the management of urothelial carcinoma of the bladder. Bolenz and Lotan outline the search for candidate biomarkers in this disease, and discuss the obstacles to their use in routine clinical practice.

Sacral neuromodulation (SNM) has been investigated as a treatment for a range of refractory lower urinary tract disorders. In this Review, Kessler and Fowler discuss developments in SNM techniques and technology, assess patient outcomes, and consider potential mechanisms of action for this therapy.

Androgen receptor activation and signaling have a key role in the pathogenesis of castration-resistant prostate cancer. In this Review, Reid and colleagues assess the possible therapeutic strategy of inhibiting androgen biosynthesis by blocking the function of the enzyme CYP17.

Stem cell therapies and regenerative medicine promise to revolutionize the treatment of many urological disorders. Here, Aboushwareb and Atala review the techniques used to generate stem cells for therapeutic applications, and discuss their potential for reconstructing the urinary tract, treating urinary incontinence, understanding prostate dysfunction and restoring fertility.

Bacterial biofilms are common in patients with indwelling urinary catheters, and crystalline biofilms in particular can cause serious complications. In this Review, Stickler describes the biological, physical and chemical factors that can lead to crystalline biofilm formation, and the current and potential future management of crystalline biofilms.

Modifications and refinements of standard laparoscopic instrumentation have led to an increasing interest in the use of single-incision surgery for urological procedures. In this Review, the authors discuss the terminology for this new type of surgery, the advances in laparoscopic instrumentation, and the results of single-incision urological surgery.

Benign prostatic hyperplasia (BPH) is one of the most common urological disorders in men, and standard treatment is transurethral resection of the prostate. In this Review, Baazeem and Elhilali assess the current evidence on other surgical options for the treatment of BPH.

Wilms tumor is the most common malignancy in children, but current survival rates are high. A new aim for treatment is to reduce the morbidity associated with therapy. In this Review, Sonn and Shortliffe look at various management guidelines for the disorder, as well as the typical and unusual clinical presentations of Wilms tumor.

Radical cystectomy remains the gold standard for muscle-invasive bladder cancer; however, there is still debate over the best approach for managing advanced bladder cancer. In this Review, Ghoneim and Abol-Enein critically assess the current treatment options for the disorder.

Despite substantial improvement in the survival data for patients with prostate cancer, almost half of men with localized disease are not cured by surgery or radiation. In this Review Mazhar and Waxman assess the potential of using chemotherapy early in the natural history of prostate cancer.

Many patients with interstitial cystitis (IC) note that particular foods can exacerbate their symptoms. In this Review, Klumpp and Rudick propose a model, based on pelvic-organ crosstalk, for this association between pain symptoms from IC and dietary modification.

The availability of medical information has enabled many patients to become well informed about their disease, and thus active participants in their care. In this Review, Hellenthal and Ellison look at patient decision making as it pertains to the treatment of urologic disease. The authors demonstrate that patients consider adverse-effect profile, treatment invasiveness and treatment efficacy to be important treatment outcomes.

Bone metastases are common among patients with primary breast, lung or prostate cancers. However, diagnosis of bone metastases can be difficult and is dependent on radiological evidence. In this Review, Zohar Dotan assesses the various imaging modalities that might be suitable for diagnosing bone metastases in patients with prostate cancer.

Prostate cancer has a wide spectrum of biological aggressiveness, but characterization of prostate-cancer aggressiveness at the time of diagnosis can be difficult. Tumor vascularization positively correlates with disease progression and, therefore, markers of angiogenesis could be indicators of clinical outcomes. Circulating endothelial progenitors and circulating endothelial cells play an integral part in neovascularization, and in this Review the authors discuss the potential of these cells as prognostic indicators.

The signs and symptoms of testosterone deficiency can be nonspecific, and can vary according to patient age and the presence of comorbid illnesses, thereby making diagnosis of the disorder difficult. In this Review, Tostain and Blanc highlight the problems and solutions in diagnosing testosterone deficiency by looking at the signs and symptoms, diagnostic tests, and epidemiology of the disorder.

Radical cystectomy is the preferred treatment for nonmetastatic muscle-infiltrating bladder cancer, but several researchers have proposed the use of bladder-sparing approaches. In this Review, Pansadoro and Emiliozzi discuss a variety of possible bladder-sparing approaches and the evidence supporting their use.

Many experimental studies have reported that statins, cholesterol-lowering drugs, inhibit the growth of prostate cancer cells. In this Review, Murtola and colleagues look at the current evidence on the use of statins in the prevention of prostate cancer.

Renal call carcinoma is frequently associated with venous tumor thrombus that involves the inferior vena cava. In this Review, Karnes and Blute examine how surgical resection of these tumors should be managed, and emphasize the tactic of operating on the inferior vena cava rather than on the kidney.

Over 200,000 new diagnoses of renal cell carcinoma are made each year in the US, Europe and Australia. Surgical resection is the standard treatment procedure for this disorder; however, there are concerns about what type of nephrectomy procedure will avoid positive surgical margins and high recurrence rates. In this Review, Lam and colleagues assess the different methods of nephrectomy and consider their associations with surgical margins and, therefore, patient prognosis.