Review Articles in 2014

Ureteroscopy is a valuable technique for the treatment of urolithiasis and the diagnosis of other upper urinary tract pathologies, including malignancies. In this Review, the technological advances that have improved outcomes and expanded the indications for this retrograde endoscopic approach are discussed, and potential avenues for continued evolution of the methodology are highlighted.

Quality-of-life assessment tools give patients and health-care providers a nuanced understanding not only of how long patients will survive, but also how well they will live. Bergman and Laviana describe the range of tools used to assess quality of life in men with prostate cancer.

Radiation therapy combined with androgen-deprivation therapy has become the standard-of-care treatment for patients with high-risk prostate cancer; however, superiority of this approach over other therapeutic options, such as surgery, has not been clearly demonstrated. This Review provides a comprehensive overview of the current status of surgery in the treatment of high-risk prostate cancer and highlights the findings that might underlie the increasing use of radical prostatectomy as the first-line treatment among patients with this disease.

Natural orifice transluminal endoscopic surgery (NOTES) can reduce or eliminate altogether the need for external incisions and might, therefore, improve the outcomes of surgery compared with open and even laparoscopic methodologies. Herein, the historical development, the current status and the future of NOTES nephrectomy, radical prostatectomy and cystectomy are discussed.

Current data suggest that early-onset prostate cancer is a distinct clinicopathological subtype of prostate cancer, with more rapid progression to disease-specific death than late-onset prostate cancer of similar stage and grade. Here, the authors discuss the epidemiology of early-onset prostate cancer and the unique challenges it poses.

Struvite stones are a subset of kidney stones that form as a result of UTI with urease-producing pathogens, and can cause significant morbidity and mortality if left untreated or treated inadequately. Here, we provide an overview of our current understanding of the microbiology, pathogenesis, treatment, and prevention of struvite stones.

Seminal plasma is a potential source of biomarkers of male reproductive system disorders. Drabovich et al. describe the development of seminal plasma proteomics and the progress towards the clinical use of biomarkers of male infertility and prostate cancer.

In this Review, Murphy and colleagues collate the disparate published data, enabling a better understanding of the mechanisms behind chronic pelvic pain syndrome and providing insight into ways to enhance the efficacy of treatment.

Cystinuria is a rare genetic disease leading to frequent stone formation owing to defective dibasic amino acid transport in the renal tubules and small bowel. This Review discusses current understanding cystinuria and describes its medical management from the perspective of a large UK based clinic.

In addition to surgical transurethral resection of the bladder tumour, intravesical chemotherapy with mitomycin C (MMC) is commonly used for the treatment of non-muscle-invasive bladder cancer. In this Review, approaches to optimizing MMC therapy through enhanced delivery, as well as maintenance and/or combination treatment regimens, are discussed.

Epidemiological studies suggest that the prevalence of prostate cancer in Asian men is lower than the rates observed in Asian populations resident in Western countries and in native Western individuals. Conversely, the proportion of prostate cancer cases that are metastatic seems to be higher in Asian countries. In this Review, these trends and the factors that might underlie them, particularly the influence of screening programmes, are comprehensively discussed.

Over the past decade, laser techniques have become an established alternative to transurethral resection for the treatment of benign prostatic obstruction. Rieken and Bachmann provide a comprehensive, evidence-based overview of laser treatment, including the physical properties of lasers that lend themselves to prostatic surgery and the clinical differences between the techniques.

Illicit drug use can result in a wide spectrum of urological manifestations, which urologists should be able to recognize in their patients. Here, the authors summarize the known or reported urological complications of illicit drug use, providing relevant information on the pathophysiology and clinical presentation of these manifestations.

In this article, Nadal et al. review the pathological features, biology, clinical characteristics, and diagnostic challenges of SCC of the prostate, summarize the available treatment options, and highlight promising therapeutic strategies.

In this Review, Semins and Matlaga discuss risk factors for stone development during pregnancy and consider the diagnostic challenges that acute renal colic poses for pregnant patients. They also highlight potential stone-related complications for the mother and fetus, and specific management recommendations for this unique condition.

Intravesical BCG instillation is a longstanding therapy for bladder cancer, but its mode of action is still under investigation. This Review summarises the current understanding of the requirements for effective BCG therapy, and the putative roles of normal and malignant bladder cells, as well as the immune system, in the response to BCG.

In the past two decades, improvements to the techniques of radical hysterectomy and chemoradiotherapy for the treatment of cervical cancer have led to a reduction in the associated urological complications. This Review considers the prevalence of lower urinary tract dysfunction in the era of nerve-sparing surgery and decreased radiation fields.

In this Review, Wagenlehneret al. discuss strategies to reduce rates of severe symptomatic infection and urosepsis after prostate biopsy, such as preoperative assessment (including history of fluoroquinolone intake over the past 6 months), urine culture, targeted antibiotic prophylaxis after sampling of the rectal flora, bowel preparation, and perineal prostate biopsy.

Erectile dysfunction (ED) is often overlooked in men with HIV, despite its high prevalence in affected men of all ages. In this Review, Santi and colleagues discuss the aetiology and social issues associated with ED in men with HIV, and provide useful advice for the clinician treating such patients.