Review Articles in 2015

Men of African origin are disproportionately affected by prostate cancer; in this Review, McGinley and colleagues discuss the disparities in treatment, the cancer-survivorship experience, and quality-of-life outcomes, as well as aspects that might contribute to these differences including socioeconomic, cultural, and genetic factors.

The interaction between tumour cells and their microenvironment has an important role in cancer pathogenesis. Alfano et al. review how dysregulation of the extracellular matrix and microbiota associated with the human epithelium might influence the development and progression of urothelial carcinomas.

The introduction of a targeted approach to treatment of prostate cancer requires the approval of novel medical devices. Here, authors describe the regulatory pathways that govern the approval of novel medical devices for clinical use. Owing to differences in legislation, these approval pathways differ substantially between the European Union and the USA, often resulting in patients receiving different treatments for prostate cancer in Europe, compared with the USA.

The development of novel antiandrogens and androgen synthesis inhibitors has improved the outcomes of patients with prostate cancer; however, the issue of resistance to these therapies has also emerged. In light of these developments, unexpected interactions between these novel therapies and glucocorticoid signalling have been observed. Here, authors describe current knowledge of androgen–glucocorticoid signalling as a cause of drug resistance and disease progression in patients with prostate cancer.

Kisspeptin, peptide hormone that signals via the G protein-coupled kisspeptin receptor (KISS1R), has been implicated in various physiological and pathophysiological processes in the urogenital system, including roles in oocyte development, spermatogenesis and sperm capacitation, as well as in kidney physiology. In this Review, Wahab et al. discuss the urogenital roles of kisspeptin signalling, and consider the potential for kisspeptin to be used as a biomarker for the diagnosis and prognosis of urogenital carcinomas.

Neural control of micturition is a complex process, involving input from many different brain regions. In this Review, Derek Griffiths describes a simplified model of neural control of micturition that incorporates current knowledge, largely derived from functional brain imaging studies of humans and experimental animals. Consideration is also given to the effects of treatments of urinary urgency on neural control of micturition.

Penile prostheses have remained the gold-standard therapy for medically refractory erectile dysfunction (ED) since their popularization. Here, Trost and colleagues discuss the considerations for penile prosthesis placement with regard to operative techniques, adjunctive procedures, and complications, as well as device design and operative technique.

Although rare, ejaculatory duct obstruction (EDO) is a surgically correctable cause of male sexual dysfunction and male infertility due to obstructive azoospermia, and should be considered within the list of differential diagnoses for men undergoing infertility investigations. In this article, the authors discuss the anatomy, embryology and pathophysiology of EDO, and consider the current optimal diagnostic and treatment options.

The development of the ureteral access sheath (UAS) has enabled substantially greater use of ureteroscopy for minimally invasive management of diseases of the upper urinary tract. Here, the authors describe the advantages and risks associated with the routine use of UAS, and the potential for use of UAS by endourologists for a wider range of applications.

The WHO recommends voluntary medical male circumcision (VMMC) throughout East and Southern Africa, in order to reduce heterosexual HIV acquisition. In this Review, Tobian et al. consider how evidence has informed policy in this field and describe the conventional surgical procedures available. They also discuss new devices that might help to accelerate the scale-up of adult VMMC in these regions, and note the features that would be present in the 'ideal' device.

Our understanding of the epidemiology, pathophysiology, and management of premature ejaculation has increased substantially in recent years. Expert-agreed definitions of premature ejaculation are now available, which will help us to determine how best to manage patients. In this Review, Saitz and Serefoglu discuss the state-of-the-art research into this common sexual disorder, and consider the future—in particular effective clinical diagnosis and treatment options.

Imaging is critically important for the diagnosis and staging of patients with high-risk prostate cancer. While established prostate cancer staging guidelines have increased appropriate use of imaging, underuse for high-risk prostate cancer remains substantial. Several factors affect the utility of initial diagnostic imaging and, in this Review, Bjurlin and colleagues discuss the performance of conventional and emerging imaging modalities for diagnosing and staging high-risk prostate cancer.

Neurogenic ejaculation is often associated with spinal cord injury (SCI) and, therefore, affects many young men who might wish to have children in the future. Collection of sperm for assisted reproductive therapies in such patients can be carried out using a number of techniques, including penile vibratory stimulation, electroejaculation, and testicular surgery. In this Review, Fode et al. discuss the options available for sperm collection in men with SCI and suggest a stepwise approach to managing these patients.

Female urethral diverticula are rare, benign, epithelium-lined outpouchings of the urethra. Patients can present with a multitude of symptoms that are often confused with other diagnoses, leading to delayed diagnosis or misdiagnosis. In this Review, Greenwell and Spilotros describe the diagnosis and treatment of urethral diverticula in women and discuss possible adverse events and complications related to treatment.

Gender discrepancy exists in the incidence of both urothelial and kidney carcinomas, and most data support the theory that gender affects the incidence and prognosis of these malignancies. Here, Lucca et al. discuss these gender differences and the biological and environmental factors that might influence them.

Survival of patients with muscle-invasive bladder cancer is poor and none of the targeted agents that are approved for cancer therapy have been approved for the treatment of bladder cancer. However, many novel targeted agents have been investigated in animal models of bladder cancer. This Review provides a comprehensive overview of targeted therapies for bladder cancer that have been investigated in animal models and have potential for clinical application.

Birt–Hogg–Dubé (BHD) syndrome is an inherited renal cancer syndrome caused by germline mutations in theFLCNgene on chromosome 17. Manifestations include benign cutaneous fibrofolliculomas, bilateral pulmonary cysts and spontaneous pneumothoraces, and kidney tumours. In this Review, Schmidt and Linehan provide an overview of BHD syndrome, discussing the molecular genetics, diagnosis, and management of this rare disorder.

The elementome—the full spectrum of elemental content—of urinary calculi is emerging as a new concept in stone research. Here, Ramaswamy et al. summarize current knowledge of the elementome of calcium-based urinary calculi and highlight study results of clinical relevance that could be shaping future therapeutic strategies in urolithiasis.

Urinary tract infections (UTIs) are very common and are a major contributor to global antibiotic use and resistance. Without effective antibiotics active against common uropathogens, many urological procedures would carry excessive risk. In this article, Zowawi and coauthors describe the current global epidemiology of resistance in Gram-negative uropathogens and discuss the genetic and molecular mechanisms underlying the resistance of these phenotypes. They also examine the effect of resistance on common urological procedures and summarize various preventive and therapeutic options.

Implantation of a synthetic mid-urethral sling (SMUS) is the most widely used anti-incontinence surgery performed in women. Despite this widespread use, a dearth of knowledge of the safety, risks and potential complications of SMUS currently exists. Here, Jerry Blaivas and co-authors draw upon the available evidence to provide an in-depth review of the risks of SMUS-associated complications.