Review Articles in 2011

Acute prostatitis is a common genitourinary disorder, which can have potentially serious sequelae in patients with immunosuppression. In this Review, the authors discuss the etiology of acute prostatitis in immunocompetent and immunocompromised patients, and the options for treating the infection and the potential complications of this disorder.

Complete testicular descent is a prerequisite for normal testicular function in adult life, and relies upon the growth and reorganization of the gubernaculum, which is regulated by the Leydig cell hormones insulin-like peptide 3 (INSL3) and testosterone. In this Review, the authors discuss the role of these hormones in testicular descent, and consider the effect ofin uterofactors, including environmental or maternal lifestyle choices, in the etiology of cryptorchidism.

Testicular cancer is one of the most curable neoplasms and mainly affects young men, meaning that complications arising from its treatment can have long-term effects. In this Review, the authors discuss the various types of adverse effects associated with chemotherapy treatment of testicular cancer, considering the etiologies of these conditions, and possible strategies for their prevention and management.

Priapism is a urological emergency and must be treated as a matter of urgency (especially ischemic priapism) to prevent erectile dysfunction. Patients with hematological or coagulative disorders, in particular, are at high risk of ischemic priapism. Morrison and Burnett provide a timely update on the management of priapism in these high-risk patients as well as discussing advances in the understanding of the etiology and pathophysiology of the condition.

Testicular microlithiasis has been linked to the testicular dysgenesis syndrome, and is thought to be a precursor of testicular germ cell tumor. In this Review, the authors discuss the prevalence of testicular microlithiasis, and its pathogenesis, including a putative link with β–estradiol. They also consider the differing management strategies for three main patient groups diagnosed with testicular microlithiasis.

The pathogenesis and treatment of prostate cancer is complex and challenging, and the development of useful biomarkers for disease progression would be extremely valuable to clinicians and patients making treatment decisions. In this Review, the authors suggest a series of algorithms, making up a clinical 'roadmap' of prostate cancer pathogenesis and management. This device could help in identifying points in the prostate cancer timeline where biomarkers are most needed.

Here, the authors briefly describe the mechanisms of citrate therapy for hypocitraturic nephrolithiasis before summarizing the available data on different dietary therapies, including lemonade, carbonated beverages and protein intake.

Historically, detrusor overactivity has served as a clinical biomarker for overactive bladder, although there is a significant lack of evidence to support its use. Here, Cartwright and colleagues describe the hunt for new biomarkers of overactive bladder, including measurements of urinary, genetic and anatomical parameters.

Surgery is the gold standard treatment for patients with chronic Peyronie's disease. Here, Kadioglu and colleagues discuss the current surgical options for such patients, which include reconstructive surgeries based on shortening or lengthening the tunica albuginea, and penile prosthesis implantation with or without grafting.

Intraprostatic androgens are derived from adrenal androgens, as well as testicular sources—a fact which is not taken into account when castration is used as a sole treatment for prostate cancer. In this Reviews, the author discusses the endocrinology of the prostate, and considers the evidence for combined androgen blockade as a more effective therapy for localized and metastatic prostate cancer.

Infertility is a common problem, and its treatment an evolving field. In this Reviews, the authors discuss the evaluation of men who present with difficulty in initiating a pregnancy, describe the various tests available, and note their indications for use, focusing on the therapies currently available to treat male factor infertility, and considering future directions in the management of this condition.

Although pTa low-grade papillary bladder tumors are at low risk for progression, one-third will recur within 5 years. With this in mind, Falke and Witjes discuss the clinical pathway of low-risk bladder cancer based on current guidelines, from diagnosis using classification systems to treatment options and recommended follow-up.

The involvement of androgens in the development of BPH is widely accepted, but new evidence suggests a role for estrogens too. Ho and Habib describe the prostatic expression and function of key components of each signaling pathway, paying particular attention to how therapeutic inhibition can be utilized for clinical management of BPH.