Current Opinion in Urology

PURPOSE OF REVIEW: Our aim is to review recent investigations into the recurrence of urothelial carcinoma in the upper urinary tract following bladder cancer therapy focusing on surveillance and management. RECENT FINDINGS: After radical cystectomy, rates of recurrence in the upper tract are between 0.75 and 6.4%. The poor prognosis of upper tract urothelial carcinoma (UTUC) is in part attributable to delayed diagnosis. Guidelines recommend a gradual de-escalation of surveillance in disease-free patients with the potential for discontinuation beyond 5 years...

PURPOSE OF REVIEW: Bacillus Calmette-Guérin (BCG) is the standard immune therapy for nonmuscle invasive bladder cancer. A systematic review of published articles regarding BCG treatment of bladder cancer was conducted and a commentary of these is provided to gain a perspective of the current major developments in the field. RECENT FINDINGS: Several BCG strains are utilized worldwide. As the understanding of genetic and phenotypic differences in these strains is elucidated, inquiries into the potential clinical effects of these various strains have been studied...

PURPOSE OF REVIEW: To evaluate contemporary sex-specific differences in upper tract urothelial carcinoma (UTUC) by reviewing diagnostic considerations, clinicopathologic features, oncologic outcomes, environmental exposures, and regional variation in UTUC by sex. RECENT FINDINGS: Although some contemporary studies implicate sex-based differences in UTUC, the literature concerning the effect of sex on clinicopathologic features and oncologic outcomes in UTUC reveals mixed findings...

PURPOSE OF REVIEW: To give an overview of current options for conservative treatment of patients failing intravesical bacillus Calmette-Guerin (BCG) and to discuss emerging approaches with potential future clinical applications. RECENT FINDINGS: Radical cystectomy is the standard-of-care for patients failing BCG therapy. In patients unfit or unwilling to undergo surgery, salvage therapy options could be proposed with the aim to offer local cancer control and prevent progression to muscle-invasive disease...

PURPOSE OF REVIEW: We review historical aspects and current status of the emerging approach of robotic urinary diversion (rUD). Established surgical principles of constructing a low-pressure, large-capacity reservoir are described and the open surgical literature succinctly reviewed to establish the gold standard. Incontinent and continent rUD types [ileal conduit, orthotopic neobladder (all varieties), continent cutaneous diversion, cutaneous ureterostomy] and techniques (extra-corporeal, intra-corporeal) are discussed...

PURPOSE OF REVIEW: Penile cancer is a rare disease with significant physical and psychosocial morbidity. It has a propensity to spread to the inguinal lymph nodes where it can progress to the pelvis and beyond. Here, we present a contemporary review on the surgical management of the lymph nodes. RECENT FINDINGS: Appropriate management of the lymph nodes is critical, and has been shown to impact survival for these patients. Those with lower stage disease can achieve cure with inguinal lymph node dissection (ILND), whereas a multidisciplinary approach is required in those with more extensive disease...

PURPOSE OF REVIEW: We aim to provide a review of the literature to summarize the potential causes that lead to a disparity in infertility evaluation and the implications of male factor infertility. RECENT FINDINGS: Owing to current social constructs, women are more likely to seek medical attention and establish reproductive health evaluation at an earlier age. The male factor evaluation in infertility usually gets delayed and can contribute to a couple's inability to conceive...

PURPOSE OF REVIEW: To provide an overview of the current state of literature on organ-sparing approaches in penile cancer. Surgical as well as nonsurgical approaches can be adapted in the right setting, in an effort to spare patients from the burden of total or subtotal penectomy wherever possible. In this review, we focus on surgical approaches. RECENT FINDINGS: Narrower surgical margins do not seem to affect overall survival rates, neither do local recurrences...

PURPOSE OF REVIEW: In penile cancer, lymphadenectomy can have staging and possibly therapeutic values. However, many physicians and patients are reluctant when it comes to inguinal lymph node dissection (ILND) due to high rate of surgical morbidities. In recent years, minimally invasive surgical approaches have shown success in reducing perioperative morbidities. RECENT FINDINGS: Newer surgical modalities, including videoscopic inguinal lymphadenectomy and robotic-assisted inguinal lymphadenectomy, have been explored to reduce the morbidities of ILND while not compromising oncologic outcomes...

PURPOSE OF REVIEW: This review discusses new findings in penile cancer imaging in relation to the European Association of Urology and National Comprehensive Cancer Network guidelines. RECENT FINDINGS: For imaging in penile cancer patients who are candidates for organ-sparing primary treatment, ultrasound with Doppler seems to be the method of choice in addition to physical examination. The sentinel node biopsy (SNB) procedure is used to detect small nodal metastases in clinically node-negative patients...

PURPOSE OF REVIEW: Robotic-assisted laparoscopic retroperitoneal lymph node dissection (R-RPLND) is gaining acceptance as an alternative to open and laparoscopic RPLND for the treatment of testicular cancer. We discuss the current state of R-RPLND and summarize the latest relevant literature regarding the feasibility of this operation. RECENT FINDINGS: R-RPLND has been utilized effectively for both treatment of high-risk, clinical stage I testicular cancer as well as in the postchemotherapy setting...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

PURPOSE OF REVIEW: To elucidate the keywords big data and artificial intelligence and corresponding literature in the field of urolithiasis. RECENT FINDINGS: Numbers of publications on big data and artificial intelligence in the field of urolithiasis are rising, but still low. Most publications describe the development, testing, and validation of automated computational analyses of clinical data sets and/or images in a preclinical setting. SUMMARY: In the field of digital health services, there is a discrepancy between the enormous commitment of large private companies and investments of public funds...

PURPOSE OF REVIEW: We present a review of recent literature to summarize the most recent evidence on the use of ureteral stents, including the use of different materials and treatment of stent-related symptoms. RECENT FINDINGS: Metal stents are able to resist lumen occlusion from extrinsic compression allowing longer indwelling time and making them an option for long-term use. Biodegradable stents have the advantage not to require secondary procedures; however, they have not proven their safety in the clinical setting yet...

PURPOSE OF REVIEW: To provide a summary of surgical outcomes in percutaneous nephrolithotomy (PCNL) according to various techniques and tract sizes. RECENT FINDINGS: Recent literature in this field concluded that standard PCNL (sPCNL) remains the optimal treatment for stones between 1 and 2.5 cm and can be managed with tracts 14-20 F, whereas small stones less than 1.5 cm can be treated with tracts under 14 F. According to new datasets, smaller tracts can be equally effective in the treatment and might offer the possibility to reduce bleeding, length of hospital stay, postoperative pain as well as overall complication rates when compared with sPCNL...

PURPOSE OF REVIEW: In the recent past, there were numerous and promising technological developments in the field of endourology leading to tremendous changes in the management of urolithiasis. This review will try to weave ancient stone therapy with the very modern advent of flexible ureteroscopy and recent developments in robotic systems. RECENT FINDINGS: In the broad field of flexible ureteroscopy for stone surgery, new disposable scopes have been developed and established...

PURPOSE OF REVIEW: To give an overview about state-of-the-art antibiotic prophylaxis in urolithasis therapy and focus on recent publications in this field. RECENT FINDINGS: The number of high-quality publications within the recent time is limited. Preoperative inflammatory blood parameters like C-reactive protein and erythrocyte-sedimentation rate might help in prediction of postoperative systemic inflammatory response syndrome (SIRS) after percutaneous nephrolithotomy (PCNL)...

No abstract text is available yet for this article.

PURPOSE OF REVIEW: The most relevant recent findings on the use of extracorporeal shock wave lithotripsy (ESWL) in adult population to provide an insight of its role in the current and future of stone treatment. Comparing ESWL with other modalities is not in the scope of this review. RECENT FINDINGS: We conducted a PubMed/Embase search and reviewed recent publications that include relevant information on the development of ESWL. Low-rate shock waves improve stone breakage, ramping energy modalities improve stone fragmentation and have lower incidence of hematoma and kidney injury...