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Current Opinion in Urology

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https://www.readbyqxmd.com/read/28319478/recent-developments-of-the-pelvic-floor-and-lower-urinary-tract-symptoms
#1
Karl-Dietrich Sievert
No abstract text is available yet for this article.
March 17, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28319477/emerging-techniques-in-truly-minimal-invasive-treatment-options-of-benign-prostatic-obstruction
#2
Karl-Dietrich Sievert, Thomas Kunit
PURPOSE OF REVIEW: Benign prostatic enlargement is a common age-related condition, affecting over 50% of men aged more than 60 years. Side effects of medical therapy and significant morbidity of transurethral resection of the prostate and open surgery led to the development of so-called minimally invasive procedures, with the aim to be efficient but with less morbidity and shorter or no hospitalization. For this review, a systematic literature was performed. We report recent results in different treatment options for benign prostate hypoplasia (BPH) and recommend the best minimal-invasive treatment for BPH...
March 17, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306604/role-of-mri-in-low-risk-prostate-cancer-finding-the-wolf-in-sheep-s-clothing-or-the-sheep-in-wolf-s-clothing
#3
Ivo G Schoots, Caroline M Moore, Olivier Rouvière
PURPOSE OF REVIEW: In men on active surveillance for localized prostate cancer, MRI and MRI-targeted biopsies can be used prior to confirmatory or surveillance biopsy, to detect individuals with high-grade cancer (the wolf in sheep's clothing). However, some men will have low-risk disease despite adverse MRI findings (the sheep in wolf's clothing). We review the value addition of MRI-targeted biopsies in comparison to systematic transrectal ultrasound-guided biopsies, using pathological reclassification as an end-point...
March 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28306603/current-treatment-of-pelvic-organ-prolapse-correlated-with-chronic-pelvic-pain-bladder-and-bowel-dysfunction
#4
Bernhard Liedl, Klaus Goeschen, Leopold Durner
PURPOSE OF REVIEW: The purpose of this review is to critically analyze the relationship between symptoms of abnormal emptying of the bladder, urgency, pelvic pain, anorectal dysfunction and pelvic organ prolapse (POP) and to present evidence in order to show how many of the above mentioned symptoms can be cured or substantially improved by repair of specific pelvic ligaments. RECENT FINDINGS: In this review, we provide evidence to show how often these dysfunctions occur and how they can be cured in 42-94% by appropriate pelvic floor surgery in the longer term, up to 2 years...
March 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28267057/female-pelvic-floor-biomechanics-bridging-the-gap
#5
Deanna C Easley, Steven D Abramowitch, Pamela A Moalli
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support...
March 4, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28267056/active-surveillance-for-low-risk-prostate-cancer
#6
Laurence Klotz
PURPOSE OF REVIEW: The approach of active surveillance for low-risk prostate cancer has evolved in many ways since its introduction 20 years ago. There is a great deal of ongoing research addressing the molecular genetics and clinical outcome of low-risk disease, the use of MRI and biomarkers, and the role of lifestyle and dietary modifications. The major developments in the field are reviewed in this article. RECENT FINDINGS: Low risk and many cases of low-intermediate risk prostate cancer are indolent, have little or no metastatic potential, and do not pose a threat to the patient in his lifetime...
March 4, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28267055/overactive-bladder-syndrome-and-lower-urinary-tract-symptoms-after-prostate-cancer-treatment
#7
Suzanne Biers, Karl-Dietrich Sievert, Nikesh Thiruchelvam
PURPOSE OF REVIEW: To assess the contemporary literature on the prevalence, cause and management of lower urinary tract symptoms (LUTS) and bladder overactivity following treatment of prostate cancer with radical surgery, radiotherapy and minimally invasive therapies for localized prostate cancer, including cryotherapy and high-intensity focused ultrasound (HIFU). RECENT FINDINGS: Generally, the highest risk of urinary incontinence is after open radical prostatectomy (7-40%), although not all contemporary studies demonstrate a difference between open and laparoscopic techniques...
March 4, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28234750/female-urinary-microbiota
#8
Elizabeth R Mueller, Alan J Wolfe, Linda Brubaker
PURPOSE OF REVIEW: The newly discovered female urinary microbiota has the potential to deepen our understanding of urinary tract health and disease, including common lower urinary tract conditions such as urinary incontinence and urinary tract infection. The spectrum of painful bladder disorders and other less common conditions also may benefit from additional research that includes consideration of the resident bacterial community of the female bladder. The present review provides a clinical context for the rapidly emerging research regarding the female urinary microbiota and its relationships with urinary tract conditions of interest...
February 23, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28234749/role-of-mri-prebiopsy-in-men-at-risk-for-prostate-cancer-taking-off-the-blindfold
#9
Marc A Bjurlin, Andrew B Rosenkrantz, Samir S Taneja
PURPOSE OF REVIEW: We review recent literature surrounding the use of prebiopsy prostate MRI and MRI-targeted biopsy in men at risk for prostate cancer. RECENT FINDINGS: Large series have strengthened the case for the use of MRI prior to prostate biopsy to maximize the detection of clinically significant disease, reduce the detection of clinically insignificant disease, and allow for tumor localization during targeted biopsy. Prebiopsy MRI followed by targeted biopsy appears to have the ability to overcome the limitations of the standard 12-core template...
February 23, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28234748/management-of-intermediate-risk-prostate-cancer-with-active-surveillance-never-or-sometimes
#10
Selma Masic, Samuel L Washington, Peter R Carroll
PURPOSE OF REVIEW: Active surveillance has become the recommended management strategy for most patients with low-risk prostate cancer (PCa), but whether surveillance criteria can be expanded without compromising oncologic outcomes is a matter of debate. Whereas there is essentially uniform consensus that those with low-risk disease can be safely managed with AS, those with intermediate-risk disease, younger men and African-American men are often excluded. RECENT FINDINGS: Outcome data for intermediate-risk patients managed by active surveillance demonstrate acceptable oncologic outcomes, but there is also evidence that such patients have higher rates of progression, adverse disease and metastatic disease...
February 23, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28221220/impact-of-the-united-states-preventive-services-task-force-d-recommendation-on-prostate-cancer-screening-and-staging
#11
Renu S Eapen, Annika Herlemann, Samuel L Washington, Matthew R Cooperberg
PURPOSE OF REVIEW: In 2012, the United States Preventive Services Task Force (USPSTF) issued a grade 'D' recommendation against the use of routine prostate-specific antigen (PSA)-based screening for any men. This recommendation reflects critical misinterpretations of the available evidence base regarding benefits and harms of PSA screening and has influenced the nationwide landscape of prostate cancer screening, diagnosis, and treatment. RECENT FINDINGS: Following the USPSTF recommendation, a substantial decline in PSA screening was noted for all age groups...
February 17, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28221219/improving-the-evaluation-and-diagnosis-of-clinically-significant-prostate-cancer-in-2017
#12
Sigrid V Carlsson, Monique J Roobol
PURPOSE OF REVIEW: To provide an overview of the current state of the evidence and highlight recent advances in the evaluation and diagnosis of clinically significant prostate cancer, focusing on biomarkers, risk calculators and multiparametric MRI (mpMRI). RECENT FINDINGS: In 2017 there are numerous options to improve early detection as compared to a purely prostate-specific antigen (PSA)-based approach. All have strengths and drawbacks. In addition to repeating the PSA and performing clinical work-up (digital rectal examination and estimation of prostate volume), additional tests investigated in the initial biopsy setting are: %free PSA, Prostate Health Index, 4-kallikrein score, SelectMDx, and Michigan Prostate Score and in the repeat setting: %free PSA, Prostate Health Index, 4-kallikrein score, Prostate Cancer Antigen 3, and ConfirmMDx...
February 17, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28221218/underactive-bladder-detrusor-underactivity-definition-symptoms-epidemiology-etiopathogenesis-and-risk-factors
#13
Reem Aldamanhori, Christopher R Chapple
PURPOSE OF REVIEW: Lower urinary tract symptoms are bothersome and significantly impair patient's quality of life. Incomplete bladder emptying affects both men and women, and has shown to increase in incidence with aging. Incomplete bladder emptying is consequent upon an inability of the detrusor muscle to adequately contract to completely empty the bladder, with or without an increased bladder outlet resistance; this can be defined urodynamically as detrusor underactivity (DUA). The symptom complex consequent upon DUA is referred to as underactive bladder (UAB)...
February 17, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28212121/identification-and-evaluation-of-clinically-significant-prostate-cancer-a-step-towards-personalized-diagnosis
#14
Adnan Ali, Alexander Hoyle, Esther Baena, Noel W Clarke
PURPOSE OF REVIEW: Prostate cancer (PCa) diagnostics are evolving rapidly. The quest to differentiate 'clinically significant' from 'clinically insignificant' disease has gathered momentum, leading to substantial change in traditional diagnostic approaches. Herein, we review the relevant information on currently available biomarkers and assess their ability to help physicians and patients in making a shared and personalized decision based on their individual risk of harbouring clinically significant disease...
February 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28212120/neurogenic-voiding-dysfunction
#15
Petros Georgopoulos, Apostolos Apostolidis
PURPOSE OF REVIEW: This review aims to analyze and discuss all recently published articles associated with neurogenic voiding discussion providing readers with the most updated knowledge and trigger for further research. RECENT FINDINGS: They include the proposal of a novel classification system for the pathophysiology of neurogenic lower urinary tract dysfunction (NLUTD) which combines neurological defect in a distinct anatomic location, and data on bowel dysfunction, autonomic dysreflexia and urine biomarkers; review of patient-reported outcome measures in NLUTD; review of the criteria for the diagnosis of clinically significant urinary infections; novel research findings on the pathophysiology of NLUTD; and review of data on minimally and more invasive treatments...
February 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28212119/the-role-of-biomarkers-in-undiagnosed-men
#16
Hasan Dani, Stacy Loeb
PURPOSE OF REVIEW: This article intends to review biomarkers derived from blood, urine, and tissue that can aid in the diagnosis of prostate cancer (PCa). RECENT FINDINGS: PCa screening requires tools that complement prostate-specific antigen (PSA) with a higher specificity for clinically significant disease. Novel blood biomarkers, such as the Prostate Health Index (phi) and 4Kscore, utilize isoforms of PSA to more accurately predict high-grade PCa than traditional tools such as PSA and the percentage free-to-total PSA...
February 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28212118/role-of-chronic-exercise-on-pelvic-floor-support-and-function
#17
Janet M Shaw, Ingrid E Nygaard
PURPOSE OF REVIEW: To summarize recent literature about the potential role of chronic exercise on pelvic floor support and function. RECENT FINDINGS: Stress urinary incontinence is common during physical activity. Scant evidence suggests a dose-response association between higher volumes of exercise and urinary incontinence. Athletes do not appear to have greater pelvic floor muscle strength or worse pelvic floor support compared to nonathletes. Pelvic floor muscle electromyographic activity increases substantially as running speeds increase...
February 16, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28121850/editorial-introductions
#18
(no author information available yet)
No abstract text is available yet for this article.
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28085698/new-technologies-for-upper-tract-urothelial-carcinoma-management
#19
Joyce Baard, Jan Erik Freund, Jean J M C H de la Rosette, Maria P Laguna
PURPOSE OF REVIEW: Image enhancement techniques and optical diagnostic tools have emerged in the quest to improve diagnostics and treatment in patients with upper urinary tract carcinoma (UTUC). The aim of the present report is to describe their mechanisms of action and to assess the current evidence on applicability and utility in UTUC. RECENT FINDINGS: Image enhancement techniques including narrow band imaging, Image1 S, and photodynamic diagnosis aim at better visualization of malignant urothelium and especially flat tumours or carcinoma in situ which are often difficult to see with white light endoscopy...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28033149/partial-gland-ablation-in-the-management-of-prostate-cancer-a-review
#20
Timothy D McClure, Daniel J A Margolis, Jim C Hu
PURPOSE OF REVIEW: The index lesion theory has created a strong interest in partial gland ablation for men with prostate cancer. By only treating the focus of clinically significant disease and avoidance of surrounding periprostatic tissue, one may provide adequate oncologic control with minimal side effects. Accurate identification of the index lesion and effective ablation are critical for satisfactory oncologic outcomes. Herein, we review key ablative techniques used in partial gland ablation...
March 2017: Current Opinion in Urology
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