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Current Opinion in Urology

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https://www.readbyqxmd.com/read/28212121/identification-and-evaluation-of-clinically-significant-prostate-cancer-a-step-towards-personalized-diagnosis
#1
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
#2
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
#3
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
#4
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
#5
(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
#6
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
#7
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
https://www.readbyqxmd.com/read/28033148/transurethral-en-bloc-resection-of-nonmuscle-invasive-bladder-cancer-trend-or-hype
#8
Thomas R W Herrmann, Mathias Wolters, Mario W Kramer
PURPOSE OF REVIEW: Inherent limitations of conventional transurethral resection of bladder tumors as the standard approach for diagnosis and treatment of bladder cancer are well know: staging error because of insufficient assessment of resection depth as well as intravesical tumor fragmentation that complicates histopathological evaluation. The purpose of this review is to present recent clinical data on en bloc resection of bladder tumor (ERBT) that has been demonstrated to offer high potential to overcome these limitations...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28033147/miniaturization-of-percutaneous-nephrolithotomy-smaller-but-better
#9
Stephan Huusmann, Udo Nagele, Thomas R W Herrmann
PURPOSE OF REVIEW: Miniaturized percutaneous nephrolithotomy (PCNL) procedures have reached big popularity in the past years. Following the idea that decreasing the diameter of the instruments would decrease the complication rate instruments with outer diameter down to 4,8 Fr was established. In this review, we want to take a critical insight of the most popular miniaturized procedures, regarding the key advantages and disadvantages of the miniaturized instruments. RECENT FINDINGS: For all techniques displayed, a number of studies are available to support their effectivity in the given range of indication...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28027075/single-use-and-disposable-flexible-ureteroscopes
#10
Esteban Emiliani, Olivier Traxer
PURPOSE OF REVIEW: Flexible ureteroscopy has been widely developed in the last decade been nowadays one of the first line treatment options for urolithiasis and conservative management for upper tract urothelial tumors. Even though some unfavorable features of the reusable flexible scopes can limit the surgical procedure such as their availability, lack of sterilization or costly repairs. Disposable scopes have been developed with the intention of improving such problems. RECENT FINDINGS: To our knowledge, seven devices have been developed...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27997415/high-intensity-focused-ultrasound-for-focal-therapy-reality-or-pitfall
#11
Ariel A Schulman, Kae Jack Tay, Cary N Robertson, Thomas J Polascik
PURPOSE OF REVIEW: Progress in imaging, fusion software, and ablative modalities has fostered growth of the latest image-guided generation of high-intensity focused ultrasound (HIFU) for focal treatment of prostate cancer. Although early reports are encouraging, important questions remain regarding candidate selection, treatment, and outcomes. We review contemporary considerations for the use of HIFU for focal treatment of primary and radio-recurrent prostate cancer. RECENT FINDINGS: HIFU has been used to treat prostate cancer for over two decades...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27941379/can-we-improve-transurethral-resection-of-the-bladder-tumour-for-nonmuscle-invasive-bladder-cancer
#12
Esmee Iml Liem, Theo M de Reijke
PURPOSE OF REVIEW: The recurrence rate in patients with nonmuscle invasive bladder cancer is high, and the quality of transurethral resection of the bladder (TURB) tumour influences recurrence risk. We review new methods that aim to improve the effectiveness of TURB, and highlight studies of the past year. RECENT FINDINGS: Several approaches have been explored: bipolar resection is well tolerated and efficient; however, surgical outcomes are not clearly superior to monopolar resection; en-bloc resection seems feasible and well tolerated, and has the potential to improve the quality of tissue for histopathology; enhancement techniques such as photodynamic diagnosis, narrow band imaging, and Image1 S improve tumour detection, whereas photodynamic diagnosis reduces recurrence rates; high-resolution imaging modality such as confocal laser endomicroscopy may provide histopathologic information...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27906778/the-role-of-prostatic-inflammation-in-the-development-and-progression-of-benign-and-malignant-diseases
#13
Giorgio Gandaglia, Emanuele Zaffuto, Nicola Fossati, Vito Cucchiara, Vincenzo Mirone, Francesco Montorsi, Alberto Briganti
PURPOSE OF REVIEW: To evaluate the role of prostatic inflammation in the development and progression of benign and malignant prostatic diseases. RECENT FINDINGS: Preclinical studies demonstrate that the activation of a chronic inflammatory prostatic response plays an important role in the pathogenesis and progression of benign prostatic hyperplasia (BPH) and prostate cancer (PCa). Approximately 40-70% of patients with BPH-related lower urinary tract symptoms harbour chronic inflammation at pathologic evaluation...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27906777/asymptomatic-bacteriuria-to-screen-or-not-to-screen-and-when-to-treat
#14
Tommaso Cai, Bela Koves, Truls E Bjerklund Johansen
PURPOSE OF REVIEW: Asymptomatic bacteriuria (ABU) is a common clinical condition that often leads to unnecessary treatment. The purpose of this review is to outline and evaluate the most recent literature on the management of ABU. RECENT FINDINGS: The role of ABU management has been evaluated in several patient subgroups: healthy patients without identified risk factors, pregnant women, postmenopausal women, women with recurrent UTI, patients with diabetes, elderly institutionalized patients, patients with renal transplants, patients with indwelling catheters and prior to surgery...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27898456/the-role-of-nonantibiotic-treatment-of-community-acquired-urinary-tract-infections
#15
Elisabetta Costantini, Konstantinos Giannitsas, Ester Illiano
PURPOSE OF REVIEW: To summarize evidence on the efficacy of nonantibiotic treatments in the prevention of recurrent urinary tract infections (UTIs). The need for antibiotic-free regimens seems to be imperative given the worldwide rates of resistance of uropathogens to available antibiotics. RECENT FINDINGS: In the recently published literature, cranberry products and probiotics are the focus of research. They both seem to be effective in preventing recurrent UTIs compared with placebo, but their benefit becomes less clear when they are compared with antibiotics...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27898455/clinical-implications-of-the-microbiome-in-urinary-tract-diseases
#16
Andreas Hiergeist, André Gessner
PURPOSE OF REVIEW: The purpose of this review is to outline and evaluate the most recent literature on the role of the microbiome in urinary tract diseases. RECENT FINDINGS: High throughput molecular DNA sequencing of bacterial 16S rRNA genes enabled the analysis of complex microbial communities inhabiting the human urinary tract. Several recent studies have identified bacterial taxa of the urinary microbiome to impact urinary tract diseases including interstitial cystitis, urgency urinary incontinence or calcium oxalate stone formation...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27875349/the-revival-of-old-antibiotics-for-treatment-of-uncomplicated-urinary-tract-infections-in-the-era-of-antibiotic-stewardship
#17
Jennifer Kranz, Sina Helbig, Falitsa Mandraka, Stefanie Schmidt, Kurt G Naber
PURPOSE OF REVIEW: In the era of increasing antibiotic resistance worldwide, this review highlights the advantages of revival of old antibiotics for treatment of uncomplicated urinary tract infections (uUTIs). RECENT FINDINGS: Recent studies have shown that these four oral old antibiotics, fosfomycin trometamol, nitrofurantoin, nitroxoline and pivmecillinam, show no increasing antibiotic resistance against uropathogens causing uUTI, are still effective for the treatment of uUTI and exhibit only minimal or no collateral damage as compared with fluoroquinolones or third-generation cephalosporines...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27861259/tailored-perioperative-antimicrobial-prophylaxis-in-urological-surgery-myth-or-reality
#18
Magnus J Grabe, Karl-Johan Lundström
PURPOSE OF REVIEW: The controversies surrounding perioperative antimicrobial prophylaxis (AMP) are about the use and especially misuse of antibiotics. The overall lack of evidence to facilitate a rational perioperative AMP policy in urological surgery and the postoperative infectious complications remain a challenge. Therefore, a basic tool to aid decision-making would be useful. A model based on the patients' risk factors, the level of contamination and grading of surgical procedures is discussed...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27846034/an-update-on-classification-and-management-of-urosepsis
#19
Florian M E Wagenlehner, Zafer Tandogdu, Truls E Bjerklund Johansen
PURPOSE OF REVIEW: The urinary tract is the infection site in severe sepsis/septic shock in 10-30%. RECENT FINDINGS: There is a new Sepsis definition focusing on severe sepsis. Urosepsis is mainly due to obstructed uropathy of the upper urinary tract. The pathogenesis of sepsis is complex and is driven by the innate immune system. In the further course immunosuppression is developing.Management of urosepsis includes early diagnosis, early initiation of treatment such as identification and control of the complicating factor in the urinary tract and the specific sepsis therapy...
March 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27846033/brush-cells-the-newly-identified-gatekeepers-of-the-urinary-tract
#20
Wolfgang Kummer, Klaus Deckmann
PURPOSE OF REVIEW: A specialized epithelial cell with chemosensory properties of taste cells known from the mouth has been newly identified in the urethra and linked to pathogen recognition. We here describe its properties and its link to defence mechanisms, showing parallels to similar sentinel cells in the respiratory and gastrointestinal tract. RECENT FINDINGS: In the urethra, slender epithelial cells with apical microvilli ('brush cells') express bitter and umami taste receptors and the downstream signalling cascade known from oropharyngeal gustation, utilizing it to monitor for bacterial products and bacterial growth facilitating conditions...
March 2017: Current Opinion in Urology
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