A review of thulium-fiber laser in stone lithotripsy and soft tissue surgery
Purpose of review To evaluate emerging evidence and practical applications of thulium-fiber laser (TFL) for genitourinary soft tissue disease and urinary stone disease treatment. Recent findings A systematic review was developed using the PubMed, ScienceDirect, Wiley, SpringerLink and Mary Ann Liebert Scopus databases between 2012 and 2020 years, using the PRISMA statement. We analyzed recent publications including in vitro and in humans outcomes of surgery using TFL. This new laser technology can be used in soft tissue diseases and stones present in the genitourinary system. Most of the comparisons are made with the ...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: SPECIAL COMMENTARY Source Type: research

Nonantibiotic treatments for urinary cystitis: an update
Purpose of review Urinary tract infections (UTIs) are one of most common infections in everyday clinical practice. Given the increase in antimicrobial therapy resistance, there has been an increased interest in nonantibiotic treatment options for common infections. Recent findings A review of the recent literature including on nonantibiotic options for management of UTIs, symptoms of cystitis and prevention of recurrent UTIs. Summary The article provides an overview on alternative therapy to antibiotics in the treatment of cystitis and recurrent UTI prophylaxis, including alkalinization of urine, cranberry products...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: INFECTION STEWARDSHIP IN UROLOGY: Edited by Benjamin Pradere and Richard K. Lee Source Type: research

The best rules for antimicrobial stewardship in urogenital tract infections
Purpose of review Urinary tract infections (UTIs) belong to the most common community-acquired and nosocomial infections, but therapy of UTIs is limited by resistance of pathogens and nonoptimal using of antibacterials. Narrative review of recent (2020–2018) literature dedicated to antimicrobial stewardship (AMS) in urological infections has been done. Recent findings Analysis of recent 64 articles has shown following principles of AMS for UTIs: selecting the correct drug, correct dose, and shortest clinically effective duration of therapy whenever possible, is a base for optimal antimicrobial stewardship; sympt...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: INFECTION STEWARDSHIP IN UROLOGY: Edited by Benjamin Pradere and Richard K. Lee Source Type: research

New paradigms in the management of recurrent urinary tract infections
Purpose of review Recurrent urinary tract infections (rUTIs) represent a large burden on the healthcare system. Recent guidelines from the AUA/CUA/SUFU and advancements in the field reflect a paradigm shift for clinician and patients, steering away from empiric antibiotic therapy towards judicious antibiotic use. Recent findings Antibiotic stewardship, including increasing awareness of the collateral damage of antibiotics and the risks of bacterial resistance are a major focus of the new guidelines. Accurate diagnosis of rUTIs is imperative. Urine cultures are necessary to document rUTI and should be obtained prior to...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: INFECTION STEWARDSHIP IN UROLOGY: Edited by Benjamin Pradere and Richard K. Lee Source Type: research

Editorial: A new paradigm in treating urinary infections?
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: INFECTION STEWARDSHIP IN UROLOGY: Edited by Benjamin Pradere and Richard K. Lee Source Type: research

Pathomics in urology
Purpose of review Pathomics, the fusion of digitalized pathology and artificial intelligence, is currently changing the landscape of medical pathology and biologic disease classification. In this review, we give an overview of Pathomics and summarize its most relevant applications in urology. Recent findings There is a steady rise in the number of studies employing Pathomics, and especially deep learning, in urology. In prostate cancer, several algorithms have been developed for the automatic differentiation between benign and malignant lesions and to differentiate Gleason scores. Furthermore, several applications hav...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

VR and machine learning: novel pathways in surgical hands-on training
This article reviews advances in the use of machine learning and artificial intelligence applied to virtual reality based surgical training over the last 5 years. Recent findings Eight articles have been published which met the inclusion criteria. This included six articles about the use of machine learning and artificial intelligence for assessment purposes and two articles about the possibility of teaching applications, including one review and one original research article. All the research articles pointed out the importance of machine learning and artificial intelligence for the stratification of trainees, based on...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Machine learning in the optimization of robotics in the operative field
Purpose of review The increasing use of robotics in urologic surgery facilitates collection of ‘big data’. Machine learning enables computers to infer patterns from large datasets. This review aims to highlight recent findings and applications of machine learning in robotic-assisted urologic surgery. Recent findings Machine learning has been used in surgical performance assessment and skill training, surgical candidate selection, and autonomous surgery. Autonomous segmentation and classification of surgical data have been explored, which serves as the stepping-stone for providing real-time surgical assessm...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Applications of neural networks in urology: a systematic review
Purpose of review Over the last decade, major advancements in artificial intelligence technology have emerged and revolutionized the extent to which physicians are able to personalize treatment modalities and care for their patients. Artificial intelligence technology aimed at mimicking/simulating human mental processes, such as deep learning artificial neural networks (ANNs), are composed of a collection of individual units known as ‘artificial neurons’. These ‘neurons’, when arranged and interconnected in complex architectural layers, are capable of analyzing the most complex patterns. The aim o...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Artificial intelligence in the diagnosis, treatment and prevention of urinary stones
This article reviews advances in the use of artificial intelligence for the diagnosis, treatment and prevention of urinary stone disease over the last 2 years. Pertinent studies were identified via a nonsystematic review of the literature performed using MEDLINE and the Cochrane database. Recent findings Twelve articles have been published, which met the inclusion criteria. This included three articles in the detection and diagnosis of stones, six in the prediction of postprocedural outcomes including percutaneous nephrolithotomy and shock wave lithotripsy, and three in the use of artificial intelligence in prevention o...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Impact of radiomics on prostate cancer detection: a systematic review of clinical applications
Purpose of review To systematically review the current literature to assess the role of radiomics in the detection and evaluation of prostate cancer (PCa). Recent findings Radiomics involves the high-throughput extraction of radiologic features from clinical imaging, using a panel of sophisticated data-characterization algorithms to make an objective and quantitative determination of diagnoses and clinical characteristics. Radiomics evaluation of existing clinical images would increase their clinical value in many cancer management pathways, including PCa. However, a consensus on the implementation of radiomics has no...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Clinical applications of artificial intelligence in urologic oncology
Purpose of review This review aims to shed light on recent applications of artificial intelligence in urologic oncology. Recent findings Artificial intelligence algorithms harness the wealth of patient data to assist in diagnosing, staging, treating, and monitoring genitourinary malignancies. Successful applications of artificial intelligence in urologic oncology include interpreting diagnostic imaging, pathology, and genomic annotations. Many of these algorithms, however, lack external validity and can only provide predictions based on one type of dataset. Summary Future applications of artificial intelligence wil...
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Editorial: Artificial intelligence and simulation in urology
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE AND SIMULATION IN UROLOGY: Edited by Domenico Veneziano and Quoc-Dien Trinh Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - October 3, 2020 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Bladder-preserving strategies for Bacillus Calmette-Guérin unresponsive non-muscle invasive bladder cancer; where are we and what will be expected?: Erratum
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: ERRATUM Source Type: research

Cytoreductive nephrectomy for favorable risk patients with metastatic renal cell carcinoma? No, cytoreductive nephrectomy should no longer be routinely performed
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Cytoreductive nephrectomy for favorable risk patients with metastatic renal cell carcinoma? Yes, cytoreductive nephrectomy should still be considered
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Secretion of severe acute respiratory syndrome coronavirus 2 in urine
Purpose of review Despite the plethora of publications discussing the severe respiratory coronavirus 2 (SARS-CoV-2), evidence of viral secretion in urine is sparse. Recent findings We could identify 34 publications including a total of 2172 patients. Among those, 549 patients were tested for SARS-CoV-2 secretion in urine, which was detected in only 38 patients (6.9%). Within the seven studies displaying positive results, the majority of positive patients (86.8%) was from not yet peer-reviewed studies including weak data and heterogeneous techniques for sample testing. Furthermore, none of the studies available in the ...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: SPECIAL COMMENTARY Source Type: research

Outcomes of loco-regional anaesthesia in ureteroscopy for stone disease: a systematic review
Purpose of review Routine ureteroscopy (URS) for stone disease is performed under a general anaesthesia. However, controversy exists on the role of loco-regional anaesthesia and the outcomes associated with it. Here we review the challenges, outcomes and complications of loco-regional anaesthesia for URS. A Cochrane style review was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines to evaluate the outcomes of loco-reginal anaesthesia for URS in stone disease, including all English language articles from January 1980 and December 2019. Recent findings Twenty-...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

Smoking and bladder cancer: review of the recent literature
Purpose of review This review summarizes the current knowledge regarding the relationship between smoking and bladder cancer (BCa), especially with respect to treatment outcomes for muscle and nonmuscle-invasive BCa (MIBC/NMIBC). Recent findings PubMed/Medline databases were searched for recent reports investigating the association of smoking with BCa. Smoking is associated with an increased risk of recurrence in patients with NMIBC and may impair Bacillus Calmette-Guerin treatment efficacy. Moreover, smoking is associated with poor responses to neoadjuvant chemotherapy, poor survival outcomes and high complication ra...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

mpMRI-targeted biopsy versus systematic biopsy for clinically significant prostate cancer diagnosis: a systematic review and metaanalysis
Purpose of review We aimed to compare the accuracy of clinically significant prostate cancer (csPCa) diagnosis by magnetic resonance imaging-targeted biopsy (MRI-TB) versus systematic biopsy (SB) in men suspected of having prostate cancer (PCa). Recent findings In biopsy-naïve patients, MRI-TB was more accurate to identify csPCa than SB. However, when comparing specifically MRI-TB versus transperineal (SB), we did not find any difference. Furthermore, in a repeat biopsy scenario, MRI-TB found more csPCa than SB as well. Finally, postanalysis comparing combined biopsy (SB plus MRI-TB) suggests that the later alone...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

Impact of hospital and surgeon volumes on short-term and long-term outcomes of radical cystectomy
Purpose of review There is heightened awareness and trends towards centralizing high-risk, complex surgeries such as radical cystectomy to minimize complications and improve survival. However, after nearly a decade of mandated and/or passive centralization of care, debate regarding its benefits and harms continues. Recent findings During the past decade, mandated and passive centralization has led to an increase in radical cystectomies performed in high-volume hospitals (HVHs) and, perhaps by high-volume surgeons (HVS), in addition to efforts to increase the uptake of multidisciplinary strategies in the management of ...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

Volume outcome relationship in penile cancer: a systematic review
Purpose of review Penile cancer is a rare disease with significant morbidity. Because of the low volume of cases, it has been suggested that its treatment should be centralized in order to improve outcomes through better management of both the primary tumor and distant disease. We reviewed and summarized the most relevant recent publications regarding centralization of penile cancer management. Recent findings Management of penile cancer in academic and supra-regional centers was associated with better survival outcomes. Moreover, reports from population-based studies showed more adherence to guidelines recommendation...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

Aristolochic acid and its effect on different cancers in uro-oncology
Purpose of review To acquaint urologists with aristolochic acid nephropathy, an iatrogenic disease that poses a distinct threat to global public health. In China alone, 100 million people may currently be at risk. We illustrate the power of molecular epidemiology in establishing the cause of this disease. Recent findings Molecular epidemiologic approaches and novel mechanistic information established a causative linkage between exposure to aristolochic acid and urothelial carcinomas of the bladder and upper urinary tract. Noninvasive tests are available that detect urothelial cancers through the genetic analysis of ur...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

An up-to-date catalogue of urinary markers for the management of prostate cancer
Purpose of review Prostate cancer (PCa) is the most commonly diagnosed cancer in men. Poor specificity and sensitivity of total PSA often results in over and sometimes underdetection/treatment. Therefore, more specific and sensitive biomarkers for the detection and monitoring especially of clinically significant PCa as well as treatment-specific markers are much sought after. In this field, urine has emerged as a promising noninvasive source of biomarkers. Recent findings RNA-based biomarkers are the most extensively studied type of urinary nucleic acids. ERG-Score/MiPS (Mi-Prostate Score) and SelectMDx might be consi...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

Tubeless percutaneous nephrolithotomy: evaluation of minimal invasive exit strategies after percutaneous stone treatment
Purpose of review To provide an updated overview of different exit strategies for percutaneous nephrolithotomy (PCNL) in times of miniaturization and minimal invasive surgery. Recent findings The majority of the reported studies concluded that a tubeless procedure is associated with less patient discomfort and a shorter hospital stay compared to the standard PCNL. Additionally, no significant difference in the complication rate was observed, including postoperative fever, hematocrit decrease, stone-free rate, and urine extravasation. Summary Underlined by recent literature tubeless PCNL is a well tolerated and effe...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: CONTROVERSIES IN UROLOGY: Edited by Shahrokh F. Shariat Source Type: research

Where to next prostate-specific membrane antigen PET imaging frontiers?
Purpose of review Technical improvements in imaging equipment and availability of radiotracers, such as PSMA-ligands have increased the synergy between Urology and Nuclear Medicine. Meanwhile artificial intelligence is introduced in Nuclear Imaging. This review will give an overview of recent technical and clinical developments and an outlook on application of these in the near future. Recent findings Digital PET/CT has shown gradual improvement in lesion detection and demarcation over conventional PET/CT, but total-body PET/CT holds promise for a magnitude of improvement in scan duration and quality, quantification, ...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

PET imaging in testicular tumours
Purpose of review Testicular cancer is rare, but its incidence is expected to rise. [18F] fluorodeoxyglucose ([18F]FDG) PET/computed tomography (CT) added role in testicular cancer management has been defined in a set of specific clinical settings. The current review focuses on recent advances in the employment of PET/CT in testicular cancer patients. Recent findings [18F]FDG PET/CT is not recommended for initial staging or for suspected testicular tumours. PET/CT role in testicular cancer management is mainly for the assessment of seminoma residual masses after therapy (>3 cm). Although [18F]FDG PET/CT has a ver...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in muscle-invasive bladder cancer
Purpose of review In this narrative review, we assessed the role of 18F-fluoro-2-deoxy-D-glucose-positron emission tomography/CT (FDG-PET/CT) in preoperative staging and response evaluation of neoadjuvant chemotherapy in muscle-invasive bladder carcinoma (MIBC), and to assess its incremental value to contrast-enhanced (CE)CT and MRI in terms of patient management at initial diagnosis and detection of recurrence. Recent findings A literature search in PubMed yielded 46 original reports, of which 15 compared FDG-PET/CT with CECT and one with MRI. For primary tumor assessment, FDG-PET/CT proved not accurate enough (13 re...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

Clinical impact of PET imaging in prostate cancer management
Purpose of review Imaging of prostate cancer has been a rapidly evolving field in recent years with the introduction of multiple new PET tracer agents. Introduction of novel imaging techniques into clinical practice requires careful evaluation, with the ultimate aims of improved patient outcomes, better sequencing of treatments, and cost effectiveness. The increased sensitivity and specificity of these new PET agents present both challenges and opportunities. We know they frequently change management, but are these effective management changes, and is it always in the best interests of the patients? Recent findings Th...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

Clinical application of Fluciclovine PET, choline PET and gastrin-releasing polypeptide receptor (bombesin) targeting PET in prostate cancer
Purpose of review The aim of this review is to explore the clinical application of different PET radiopharmaceuticals in prostate cancer (PCa), beyond inhibitors of the prostate-specific membrane antigen (PSMA). Recent findings Choline PET represented in the last decades the standard of reference for PET imaging in PCa and has been recently included in clinical trials evaluating the efficacy of metastasis-directed therapy in oligo-metastatic disease. Fluciclovine, as synthetic amino acid, has been proposed for investigating PCa. The results obtained by the first prospective studies led to FDA approval in 2016 in patie...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

Prostate-specific membrane antigen targeted PET imaging for prostate cancer recurrence
Purpose of review Prostate-specific membrane antigen targeted PET imaging (PSMA PET) of biochemically recurrent prostate cancer (BCR) is implemented in routine management in many countries and recommended in European Association of Urology (EAU) and American Society of Clinical Oncology (ASCO) guidelines. Purpose of this review is to summarize recently published evidence of accuracy, management impact, and clinical benefit of PSMA PET in this setting and to state our opinion on the role of PSMA PET in future trials and clinical routine to improve patient outcomes. Recent findings The past two years saw an increase of ...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

Prostate-specific membrane antigen PET/computed tomography for staging prostate cancer
Purpose of review Molecular imaging with PET/CT targeting the prostate-specific membrane antigen (PSMA) receptor is increasingly utilized in men with prostate cancer (PCa), with clinical indications now expanding beyond biochemical recurrence. PSMA PET/CT often detects sub-centimetre size pathologic nodes and low-volume bone marrow disease that are occult on conventional imaging when the lesion does not cause sclerosis or osteoblastic reaction in surrounding bone. This review focuses on recent evidence for PSMA PET/CT in initial disease staging. Recent findings Several recent studies including a large randomized trial...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

PET imaging in urology: a rapidly growing successful collaboration
Purpose of review To discuss and highlight the recent findings in urological oncology focusing on nuclear medicine advances on imaging and therapy. Recent findings Testicular tumors: 18F-FDG as the standard positron emission tomography (PET) tracer with proven good accuracy in detecting metastatic testicular cancer; urothelial cancer: good accuracy of 18F-FDG PET in detecting distant metastases but poor results in detecting local disease; prostate cancer: prostate-specific membrane antigen (PSMA) is a promising target for imaging prostate cancer with unprecedented accuracy in both staging and restaging and prospective...
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: PET IMAGING IN UROLOGY: Edited by Stefano Fanti and Declan G. Murphy Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - August 3, 2020 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Chemotherapy, not androgen receptor-targeted therapy should be used upfront for metastatic hormone-sensitive prostate cancer. CON: Novel oral agents provide an attractive alternative to chemotherapy in metastatic hormone-sensitive prostate cancer
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Chemotherapy, not androgen receptor-targeted therapy should be used upfront for metastatic hormone-sensitive prostate cancer. PRO: docetaxel chemotherapy should be the default consideration in metastatic hormone-sensitive prostate cancer
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Where do urologists stand in the era of novel coronavirus-2019 disease
Purpose of review The novel coronavirus-2019 disease (COVID-19) pandemic has had devastating consequences on healthcare systems globally. The effect this has on urologists and the patients they care for is not fully understood and presents the challenge of prioritizing the most urgent cases. We aim to review the impact on urology services and evaluate strategies to minimize disruption. Recent findings Various healthcare systems have been forced to postpone treatment for many urological conditions as resources are dedicated to the treatment of COVID-19. Training has been postponed as staff are reallocated to areas of n...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Metastasectomy in patients with renal cell carcinoma: when and how?
Purpose of review The role of metastasectomy in the management of metastatic renal cell carcinoma (mRCC) remains controversial. The aim of this review is to summarize and evaluate the recent findings about the surgical treatment of patients with mRCC focusing on the literature published in the last 2 years. Recent findings Despite the lack of randomized controlled trials, the benefit of metastasectomy in term of cancer-specific and overall survival have been demonstrated in large observational studies. Results of ongoing clinical trials evaluating the impact of combination of surgical and systemic therapies are eagerl...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Novel therapies for advanced urologic cancers
Purpose of review Systemic treatment of advanced urogenital malignancies has changed significantly in recent years and it will continue to change rapidly in upcoming years. It is the scope of this review article to providing the reader with the most recently approved treatment strategies to be used in daily routine for the individualized and most optimal treatment of our patients. Recent findings Immunooncological therapy (IOT) has emerged as the treatment of choice in metastatic renal cell carcinoma and we describe the most relevant clinical trials and we will give some differential therapeutic recommendation who mig...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Bladder-preserving strategies for Bacillus Calmette-Guérin unresponsive non-muscle invasive bladder cancer; where are we and what will be expected?
Purpose of review Bacillus Calmette-Guérin (BCG) unresponsive non-muscle invasive bladder cancer (NMIBC) is a new definition including patients who failed intravesical BCG therapy and should not receive more BCG because of the very low efficacy and disproportionately poor prognosis. Radical cystectomy as the standard of care for these patients is associated with significant morbidity and altered quality of life. Therefore, the FDA has accepted phase II single-arm studies as a threshold to approve new agents in this setting. Recent findings Efforts to find an effective and safe bladder sparing strategy for BCG u...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Systemic treatment options for metastatic hormone-sensitive prostate cancer: making sense of the data
Purpose of review Systemic treatment options for metastatic hormone-sensitive prostate cancer (mHSPC) have recently shifted from the traditional androgen deprivation therapy (ADT) monotherapy to multidrug approaches incorporating drugs initially approved for castration-resistant state and ADT. However, clinicians have difficulties in choosing the adequate combination therapy for individualized patient care, because of the lack of consensus regarding disease risk factors, differences in study design of the major clinical trials and lack of direct comparisons between drugs. The aim of this review is to provide an update of...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Treatment of the primary in metastatic prostate cancer
This article emphasizes important aspects regarding a feasible management of mPCa, with possible impact on subsequent guidelines. The expected results from ongoing trials may provide another perspective in treatment of these cases. (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Fibroblast growth factor receptors across urothelial carcinoma landscape
Purpose of review Fibroblast growth factor receptor (FGFR) signalling, especially induced by FGFR3, is a crucial factor in the pathogenesis of urothelial carcinoma and was therefore extensively studied over the last decades. In this review, we summarize the most relevant findings of the past two years. Recent findings Recent studies support the concept that FGFR3 mediates a pathway of urothelial carcinogenesis associated with low malignant potential. FGFR3 may represent a highly accurate biomarker for diagnosis and prediction of recurrence, progression or therapy response. The pan FGFR-inhibitor erdafitinib was recent...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Immune checkpoint inhibition in muscle-invasive and locally advanced bladder cancer
Purpose of review Immune-checkpoint inhibitors (CPIs) have been implemented in the treatment algorithm of metastatic urothelial cancer as they have shown higher and more sustained responses compared with conventional second-line chemotherapy. Recently, several clinical trials have reported on CPIs in earlier disease stages such as muscle-invasive bladder cancer (MIBC). This review summarizes ongoing clinical trials and results from early phase clinical trials in muscle invasive and locally advanced bladder cancer. Recent findings In phase II clinical trials, neoadjuvant use of CPIs as mono and combination therapy, in ...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Bladder sparing landscape for bacillus Calmette-Guérin unresponsive bladder cancer
Purpose of review The treatment of bacillus Calmette-Guérin (BCG) unresponsive disease remains a challenge for urooncologists. The search for effective conservative treatments is ongoing and several new agents have been recently tested for this purpose. The aim of this manuscript was to review the last developments in this interesting field. Recent findings The advent of systemic immunotherapy in the nonmuscle invasive setting promise to revolutionize the paradigm of treatment of BCG unresponsive disease. The preliminary results of the Keynote-057 trial (3 months complete response of 41% in carcinoma-in-situ pa...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

PD1/PD-L1 therapy in metastatic renal cell carcinoma
Purpose of review The aim of the article to summarize recent changes of treatment options in metastatic renal cell carcinoma (mRCC) with a special emphasis on immune checkpoint inhibition. Recent findings The introduction of checkpoint inhibitor (CPI) therapy has led to a paradigm change in advanced renal cell carcinoma (RCC). Dual immune checkpoint inhibition or the combination of CPI and tyrosine kinase inhibitors (TKIs) was shown to improve survival when compared with the former standard of care sunitinib. Moreover, these novel strategies were shown to enable unprecedented rates of complete and durable responses, p...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

The role of taxane-based chemotherapy in the treatment of prostate cancer
Purpose of review Indications for chemotherapy have increased in prostate cancer (PCA), many of which are shared with new hormonal agents (NHA). With no head to head comparison available, defining the optimal sequence and identifying biomarkers to predict response, has been a focus of intense research in PCA. We aim to summarize the best currently available evidence in all stages of disease to help guide therapy. Recent findings In metastatic castration-resistant prostate cancer, Cabazitaxel has shown improved radiographic progression-free survival over another NHA after Docetaxel and one NHA. For hormone sensitive PC...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Poly(ADP-ribose) polymerase inhibitors in prostate and urothelial cancer
Purpose of review The aim of this article is to give an overview of poly(ADP-ribose) polymerase inhibitors (PARPis) trials in prostate cancer and to discuss emerging approaches with potential future clinical implementation in both prostate and urothelial cancer. Recent findings PARPis are a class of drugs that can be applied for the treatment of homologous recombination repair (HRR)-deficient tumors. Tumors are potentially sensitive to PARPi harbor mutations in genes relevant for DNA damage repair, such as BRCA1/2 or ATM, which are present to a significant degree in metastatic prostate and urothelial cancer patients. ...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NOVEL THERAPIES FOR ADVANCED UROLOGIC CANCERS: Edited by Shahrokh F. Shariat Source Type: research

Tibial nerve stimulation in the treatment of overactive bladder syndrome: technical features of latest applications
We describe the technical aspects of recent developed implants and techniques of tibial nerve stimulation in a transcutaneous, percutaneous, and minimal invasive way. All different treatment options have advantages and disadvantages based on type of surgery, energy transfer, impedance, treatment setting options, risk of migration, and patient usability, which are described in this review. Only devices with data that are publicly available were included. Summary New technologies are on their way in the field of tibial nerve stimulation for the treatment of OAB. Technical aspects are important to demonstrate safety and ef...
Source: Current Opinion in Urology - May 28, 2020 Category: Urology & Nephrology Tags: NEUROUROLOGY AND INCONTINENCE: Edited by John Heesakkers and Frank Martens Source Type: research