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Management of rare genitourinary malignancies often depends on individual physicians’ discretion, resulting in non-standardized care. Furthermore, patients experience worse clinical outcomes than patients with common malignancies. Collaborative efforts such as the Global Society of Rare Genitourinary Tumors (GSRGT) are therefore necessary.
Retzius-sparing prostatectomy is an alternative approach to standard robot-assisted radical prostatectomy. Many surgeons advocate this technique as data suggest that it provides better early functional results than the standard approach without compromising oncological outcomes.
The PRECISION trial demonstrated the ability of using multiparametric MRI to improve the diagnosis of clinically significant prostate cancer whilst reducing over-diagnosis of clinically insignificant cancer compared with systematic biopsy. Concerns remained about patients who were not biopsied owing to negative scans. A new study applies the PRECISION strategy to a contemporary cohort to answer these concerns.
Multiparametric MRI enables early detection of progression and reclassification in patients with low-risk prostate cancer on active surveillance and offers the potential to reduce unnecessary biopsies. However, the reliability and reproducibility of MRI-directed surveillance during follow-up is unclear. A recent study highlights the potential and current shortcomings of this approach.
This Review summarizes the manifestations of inter-tumoural and intra-tumoural heterogeneity in primary and metastatic prostate cancer, emphasizing the contribution of genomics studies and discussing the importance of phenotypic changes. The authors also critically discuss the implications for clinical management and research.
New and more effective treatments are urgently needed for bladder cancer. This Review discusses the role of nectin-4 as a therapeutic target for enfortumab vedotin (an antibody–drug conjugate) in locally advanced and metastatic urothelial carcinoma and outlines related clinical data.
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.
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.
