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Current Urology Reports

Ayushi P Gupta, Prerna Raj Pandya, My-Linh Nguyen, Tola Fashokun, Katarzyna J Macura
PURPOSE OF REVIEW: Approximately 25% of women in the USA suffer from pelvic floor disorders. Disorders of the anterior compartment of the pelvic floor, in particular, can cause symptoms such as incomplete urinary voiding, urinary incontinence, pelvic organ prolapse, dyspareunia, and pelvic pain, potentially negatively impacting a woman's quality of life. In some clinical situations, clinical exam alone may be insufficient, especially when patient's symptoms are in excess of their pelvic exam findings...
November 13, 2018: Current Urology Reports
Sumeet K Bhanvadia
PURPOSE OF REVIEW: Bladder cancer (BC) is the second most common genitourinary malignancy, with a growing population of survivors globally. Over the past two decades, there has been a growing awareness of not only the oncologic, but also the quality of life ramifications of a BC diagnosis, treatment, and surveillance. In the current review, the literature surrounding the many domains that encompass bladder cancer survivorship is summarized and analyzed. RECENT FINDINGS: There have been ongoing efforts to decrease perioperative morbidity, particularly in patients undergoing radical cystectomy, with mixed results...
November 9, 2018: Current Urology Reports
Gregory A Joice, Steven P Rowe, Michael A Gorin, Phillip M Pierorazio
PURPOSE OF REVIEW: Determining the metastatic viability of suspicious retroperitoneal nodes in testicular cancer with conventional imaging is challenging. The aim of this report is to review recent evidence in the utilization of novel imaging modalities to assess viable testicular cancer nodal metastases. RECENT EVIDENCE: Testicular germ cell tumors (TCGTs) follow a predictable lymphatic metastatic spread to the retroperitoneum. Accordingly, retroperitoneal imaging is critical in staging, assessing treatment response, and evaluating for recurrence...
November 9, 2018: Current Urology Reports
Abhishek Tripathi, Elizabeth R Plimack
PURPOSE OF REVIEW: Until recently, effective treatment options for patients with advanced urothelial carcinoma were limited to platinum-based chemotherapy. In the post-platinum setting and for patients ineligible for cisplatin, minimally effective second-line chemotherapy was used and outcomes were poor. The approval of immune checkpoint inhibitors has significantly changed the treatment landscape of urothelial carcinoma. Here, we review current data demonstrating their efficacy in advanced disease and ongoing trials investigating novel combination strategies...
November 7, 2018: Current Urology Reports
Adnan El-Achkar, Luis Souhami, Wassim Kassouf
PURPOSE OF THE REVIEW: This review targets the latest literature on bladder preservation therapy with emphasis on trimodal therapy (TMT), highlighting its role in the management of muscle invasive bladder cancer (MIBC) and outlining future directions in bladder preservation research. RECENT FINDINGS: TMT is the most promising bladder preservation treatment modality. Comparable results to contemporary radical cystectomy series are seen in properly selected patients...
November 3, 2018: Current Urology Reports
Thenappan Chandrasekar, Annette Erlich, Alexandre R Zlotta
PURPOSE OF REVIEW: Bladder cancer (BCa) management had remained unchanged for 20+ years with clinicians, in contrast to many other cancer types, rarely relying on molecular characteristics to guide management. The past 5 years have yielded significant advances in our knowledge of the molecular basis of BCa and concurrent advances in systemic therapy. We aim to highlight the key developments and potential future direction of BCa management. RECENT FINDINGS: Next-generation sequencing (NGS) has drastically altered the understanding of muscle-invasive BCa (MIBC) and non-muscle invasive BCa (NMIBC)...
November 3, 2018: Current Urology Reports
Laura S Leddy
PURPOSE OF REVIEW: To present the available literature pertaining to the management of lower urinary tract symptoms (LUTS) after pelvic radiation (RT) in female patients treated for pelvic malignancy. RECENT FINDINGS: Recent publications have focused on isolating de novo RT-induced LUTS in women from other contributors to urinary symptoms such as pelvic surgery and chemotherapy. There is a paucity of literature on the treatment of RT-related changes to urinary function...
October 31, 2018: Current Urology Reports
John L Gore
PURPOSE OF REVIEW: To summarize current knowledge on patient-prioritized outcomes for their bladder cancer care. RECENT FINDINGS: Patient-centered outcomes research seeks to help patients identify the right treatment for the right patient at the right time in their care. As such, patient-centered outcomes research relies on studying a treatment's impact on patient-centered outcomes. Some outcomes, like survival, are commonly prioritized by patients and by clinical experts...
October 29, 2018: Current Urology Reports
Mark A Moyad
PURPOSE OF REVIEW: To discuss the overall and latest observations of the effect of diet, lifestyle, supplements, and some prescription heart healthy medications for prostate cancer prevention. RECENT FINDINGS: The concept of maximizing heart health to prevent aggressive prostate cancer continues to be solidified with the addition of more prospective observational and randomized controlled trial data. Heart healthy is prostate healthy, but heart unhealthy is prostate unhealthy...
October 27, 2018: Current Urology Reports
Peter A Reisz, Aaron A Laviana, Sam S Chang
PURPOSE OF REVIEW: The optimal management of high-grade T1 (HGT1) urothelial carcinoma (UC) is complex given its high rate of recurrence, progression, and cancer-specific mortality as well as its clinical variability. Our current treatment paradigm has been supplemented by recent data describing the expanding options for salvage intravesical therapy, bladder preservation, and the promising role of molecular epidemiology. In the current review, we attempt to summarize and critically analyze these studies...
October 26, 2018: Current Urology Reports
Benjamin T Ristau, Marc C Smaldone
PURPOSE OF REVIEW: Bladder cancer care is costly due to long surveillance periods for non-muscle-invasive bladder cancer (NMIBC) and comorbidities associated with the surgical treatment of muscle-invasive bladder cancer (MIBC). We reviewed current evidence-based practices and propose quality metrics for NMIBC and MIBC. RECENT FINDINGS: For patients with NMIBC, we propose four categories of candidate quality metrics: (1) appropriate use of imaging, (2) re-staging transurethral resection of bladder tumor, (3) perioperative intravesical chemotherapy, and (4) induction and maintenance BCG in high-risk NMIBC...
October 24, 2018: Current Urology Reports
Timo K Nykopp, Jose Batista da Costa, Miles Mannas, Peter C Black
PURPOSE OF REVIEW: As our molecular understanding of bladder cancer continues to advance, more and more novel agents are entering clinical trials across the spectrum of bladder cancer stages. The clinical trial activity for non-muscle invasive bladder cancer (NMIBC) has been boosted further by the evolution of specific disease states that set more uniform inclusion criteria for clinical trial design. Here, we aimed to review the current clinical trials landscape in non-muscle invasive bladder cancer with respect to these disease states...
October 24, 2018: Current Urology Reports
Sima P Porten
PURPOSE OF REVIEW: Epigenetics refers to processes that alter gene expression without altering primary DNA. Over that past decade, there is a growing focus on epigenetic mechanisms in cancer research and its importance in cancer biology. This review summarizes epigenetic dysregulation in bladder cancer. RECENT FINDINGS: Epigenetic alterations are overall shared across various grades and stages of bladder cancer. High grade invasive tumors demonstrate a greater degree and intensity of methylation and may have a unique methylation pattern...
October 24, 2018: Current Urology Reports
Anthony D Oberle, Jeremy M West, Conrad M Tobert, Gabriel L Conley, Kenneth G Nepple
PURPOSE OF REVIEW: Malnutrition in a prevalent problem in patients undergoing radical cystectomy. Preoperative malnutrition has been shown to contribute to increased rates of postoperative complications. Given the significant morbidity and mortality of the procedure of radical cystectomy, there is potential for improvement in patient outcomes by nutritional intervention. RECENT FINDINGS: Prospective studies have demonstrated a reduction in postoperative infection rates in patients who receive supplemental immunonutrition prior to major surgery including radical cystectomy...
October 18, 2018: Current Urology Reports
Saum Ghodoussipour, Hooman Djaladat
PURPOSE OF REVIEW: The purpose of the study is to review and summarize major additions to the literature as pertains to enhanced recovery protocols after radical cystectomy in the past year. RECENT FINDINGS: Enhanced recovery after surgery protocols is multimodal pathways that include elements to optimize all stages of care including preoperative, intraoperative and postoperative measures. Several authors have recently presented their results with initial implementation of an enhanced recovery protocol after radical cystectomy, while others have begun to examine outcomes beyond the index admission and to refine the various targeted components of the protocol...
October 18, 2018: Current Urology Reports
Dena Moskowitz, Una Lee
PURPOSE OF REVIEW: Recurrent urinary tract infections are a common condition that can impact patients' quality of life. The purpose of this review is to summarize and analyze the literature regarding the distress that these infections can cause to patients and provide guidance to clinicians on how to improve care of these patients. RECENT FINDINGS: The current literature on patient perspectives in urinary tract infections shows an emotional symptom experience that is not consistent with the typical symptoms expected by clinicians...
October 18, 2018: Current Urology Reports
William Tabayoyong, Ashish M Kamat
PURPOSE OF REVIEW: We summarize the current literature regarding the available urinary biomarkers for the detection and surveillance of bladder cancer. RECENT FINDINGS: Four urinary biomarkers have FDA approval for the detection of bladder cancer; however, they have not supplanted cystoscopy and urine cytology as the gold standard. Recent technological advances in next-generation sequencing have allowed the field of urinary biomarker research to move beyond protein biomarkers and now include genomic, transcriptomic, and epigenetic panels...
October 17, 2018: Current Urology Reports
Benoit Peyronnet, Benjamin M Brucker
PURPOSE OF REVIEW: Post-prostatectomy overactive bladder (OAB) is a common and challenging condition to manage. The aim of the present report was to review the recent evidences regarding OAB symptoms that develop in men after prostatectomy and how to manage them. RECENT FINDINGS: The prevalence of OAB after radical prostatectomy may range from 15.2 to 37.8%. Recent studies have highlighted the role of the urethrogenic mechanism (facilitation of the urethrovesical reflex due to stress urinary incontinence (SUI)) in the genesis of post-prostatectomy OAB in a significant proportion of patients...
October 10, 2018: Current Urology Reports
Farnoosh Nik-Ahd, A Lenore Ackerman, Jennifer Anger
PURPOSE OF REVIEW: There are an estimated 33 million men and women with overactive bladder (OAB) in the USA. Despite the prevalence of OAB, it remains a frequently misdiagnosed condition. OAB has shared symptomatology with other common urologic conditions, namely recurrent urinary tract infections (UTIs). Here, we will review key distinguishing features of OAB that aid in establishing an accurate diagnosis and recent advances in OAB management. RECENT FINDINGS: Recent studies have shown that among women presenting with lower urinary tract symptoms, the majority were diagnosed with UTIs and treated without performing a urine culture as routine care...
September 13, 2018: Current Urology Reports
Cara E Morin, Morgan P McBee, Andrew T Trout, Pramod P Reddy, Jonathan R Dillman
PURPOSE OF REVIEW: In this article, we describe the basics of how magnetic resonance urography (MRU) is performed in the pediatric population as well as the common indications and relative performance compared to standard imaging modalities. RECENT FINDINGS: Although MRU is still largely performed in major academic or specialty imaging centers, more and more applications in the pediatric setting have been described in the literature. MRU is a comprehensive imaging modality for evaluating multiple pediatric urologic conditions combining excellent anatomic detail with functional information previously only available via renal scintigraphy...
September 11, 2018: Current Urology Reports
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