Bacillus Calmette-Guérin (BCG) treatment of bladder cancer: a systematic review and commentary on recent publications: Erratum
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: ERRATUM Source Type: research

Which procedure for stress urinary incontinence? Colposuspension
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Which procedure for stress urinary incontinence? Autologous fascial slings
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Which procedure for stress urinary incontinence? Synthetic slings
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Which procedure for stress urinary incontinence? Injectable
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Contemporary surgical management of stress urinary incontinence
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: POINT-COUNTERPOINT Source Type: research

Epigenetic alterations of testicular germ cell tumours
Purpose of review Testicular germ cell tumours (TGCTs) exhibit, in contrast to other cancer types, a relatively low mutational burden. However, numerous epigenetic alterations have been shown to impact TGCT. In this review, we summarize the most relevant findings of the past 2 years. Recent findings Recent studies focused on the functions of microRNAs and the impact of aberrant DNA methylation. Moreover, several epigenetic drugs with antineoplastic effects in TGCTs were identified. Summary Aberrant DNA methylation and differentially expressed microRNAs have an important effect on TGCT pathogenesis. Moreover, differ...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

The role of micro-RNAs in management of germ cell tumors: future directions
Purpose of review miRNAs 371 and 302/367 clusters are abundantly secreted in the blood of patients with active germ cell malignancy (aGCM), both seminoma and nonseminoma. The serum concentration of those micro-RNAs correlates with tumor burden and to the activity of specific treatments; therefore, representing attractive biomarkers for the diagnosis and follow-up of patients with germ cell tumors. This review summarizes the most relevant evidence supporting their clinical validity in germ cell tumors. Recent findings Several retrospective studies have reported high sensitivity and specificity of those micro-RNAs in id...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Role of primary retroperitoneal lymph node dissection in stage I and low-volume metastatic germ cell tumors
Purpose of review Early-stage testicular cancers are highly curable. Following orchidectomy, management options for stage I disease include active surveillance, nerve-sparing retroperitoneal lymph node dissection (nsRPLND) and primary chemotherapy as recommended by the current guidelines. Primary RPLND has for decades played an integral part of treatment in patients with early-stage testicular germ cell tumors (TGCT), particularly in nonseminomatous germ cell tumors (NSGCT) with focus on reducing the long-term morbidity. We review the role of RPLND in stage I NSCGT as well as stage II A/B NSGCT and as seminoma. Recent f...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Active surveillance in stage 1 disease: standard of care independent of risk factors?
Purpose of review Approximately 30% of clinical stage 1 (CS1) nonseminomatous germ cell tumours (NSGCT) and 15–20% of CS1 seminoma relapse without adjuvant treatment. Despite this, the 5-year survival for CS1 is 99%. The purpose of this review is to assess if active surveillance should be standard for all patients with CS1 testis cancer independent of risk factors. Recent findings Recent data from Princess Margaret Cancer Centre suggest a nonrisk-adapted surveillance approach avoids treatment in ∼70% of patients. Most relapse early at a median time of 7.4 months. The majority of relapses are confined to the ...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: TESTICULAR CANCER: Edited by Axel Heidenreich and Siamak Daneshmand Source Type: research

Rare benign and malignant testicular lesions: histopathology and management
Purpose of review The presence of vascular solid tumors within the testicle is considered to be malignant until proven otherwise. However, it is prudent for clinicians to be aware of rare benign and malignant intratesticular lesions as management can differ from the established treatment algorithms for germ-cell tumors. Recent findings Utilizing certain histopathologic findings can assist with the diagnosis of rare testis tumors. Often times the tumor subtypes are an important consideration in the grading and classification of the disease, which drives management. The multidisciplinary management of rare malignant tes...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: TESTICULAR CANCER: Edited by Axel Heidenreich and Siamak Daneshmand Source Type: research

Editorial: Refining the role of primary retroperitoneal lymph node dissection in the management of early-stage testicular cancer
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: TESTICULAR CANCER: Edited by Axel Heidenreich and Siamak Daneshmand Source Type: research

An update on systemic therapy for penile cancer
Purpose of review Whereas substantial advances have been made in systemic tumour therapy in the past decade, the prognosis of advanced squamous cell carcinoma (SCC) of the penis remains disproportionally poor. In this review, we aimed to present an update on systemic therapy of penile SCC highlighting the most recent data and future perspectives. Recent findings Lymph node metastases play a key role in treating and assessing the prognosis of patients with penile SCC. Data show longer overall survival with the use of adjuvant chemotherapy in patients with pelvic lymph node metastases and recent analyses lead to the dev...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Management of the penile squamous cell carcinoma patient after node positive radical inguinal lymph node dissection: current evidence and future prospects
Purpose of review The level of evidence for current (adjuvant) treatment strategies after node positive inguinal lymphadenectomy is relatively low because of a paucity of prospective studies and controversy exist between the two major guidelines. The present review aims to provide a review of current literature on the available treatment options of patients after a tumor positive inguinal lymph node dissection. Recent findings Patients without inguinal extranodal extension or less than two tumor positive inguinal nodes are at low risk of ipsilateral pelvic nodal disease. Patients with pN1 disease are unlikely to benef...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Neoadjuvant chemotherapy for lymph node-positive penile cancer: current evidence and knowledge
Purpose of review To review the latest in penile cancer treatment focusing on neoadjuvant chemotherapy in patients with regional lymph node involvement. Recent findings Patients with regional lymph node involvement from penile cancer still suffer from a poor prognosis, and the chances to achieve cure are primarily dependent on the extent of the disease. Despite multiple lines of research are indicating the need for a multimodal management of the disease upfront, the search for newer effective systemic therapies is ongoing. The available guidelines currently suggest the use of combination chemotherapy regimens includin...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Localized disease: types of reconstruction/plastic surgery techniques after glans resurfacing/glansectomy/partial/total penectomy
Purpose of review The aim of this article is to provide an overview of the current literature specific to surgery for localized penile cancer including novel reconstructive techniques. Centralization of penile cancer services in many European countries and in particular the United Kingdom has resulted in an increased proportion of men undergoing organ-sparing surgery (OSS) rather than partial or total penectomy. In this review, we focus on reconstructive techniques following surgery for the primary penile tumour. Recent findings The widespread adoption of penile preserving techniques in Europe and North America has s...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Human papillomavirus vaccination and prevention of intraepithelial neoplasia and penile cancer: review article
The objective of the current article is to promote a literature revision of the relationship between the prevention of intraepithelial neoplasms (PeIN) and invasive penile cancer, and human papillomavirus (HPV) vaccination, aiming to enumerate the pros and cons of immunization. Recent findings The immunization against the HPV is sufficiently safe and many countries have incorporated the vaccine to their immunization calendar. Compared with men, the sampling size and the evidence quality of scientific researches among the female population are more robust. Some randomized and nonrandomized studies suggest that vaccinatio...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Risk factors and molecular characterization of penile cancer: impact on prognosis and potential targets for systemic therapy
Purpose of review To provide a comprehensive summary of risk factors, molecular machinery as well as potential therapeutic targets with a particular focus on literature published in the last 2 years on prognosis and treatment of penile cancer (PeCa). Recent findings E2F, LAMC2, MAML2, ID1 and IGFBP2 proteins were demonstrated to play a critical role for aggressive tumor behavior and might predict poor survival in PeCa. PD-L1 axis was confirmed as a promising pathway to serve as a therapeutic target. A number of genetic alterations were illuminated. In clinical testing, pan-HER tyrosine kinase inhibitor dacomitinib pro...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Editorial: Updates on penile cancer management: where do we stand, and how to move forward?
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: PENIS CANCER: Edited by Oscar R. Brouwer and Daher C. Chade Source Type: research

Artificial intelligence: the future of urinary stone management?
Purpose of review To investigate the application of artificial intelligence in the management of nephrolithiasis. Recent findings Although rising, the number of publications on artificial intelligence for the management of urinary stone disease is still low. Most publications focus on diagnostic tools and prediction of outcomes after clinical interventions. Artificial intelligence can, however, play a major role in development of surgical skills and automated data extraction to support clinical research. Summary The combination of artificial intelligence with new technological developments in the field of endourolo...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Health-related quality of life in renal stone formers: are we improving?
Purpose of review Health-related quality of life (HRQOL) is a multidimensional construct measuring how disease impacts one's life. In the context of nephrolithiasis this is particularly relevant given the active and quiescent phases of the disease which may not correlate with the traditional index of stone free status. Several instruments are now available to objectively measure HRQOL in this population, including the first disease-specific instrument. Therefore, an overview of emerging data on HRQOL is provided that reviews the availability of these tools/instruments and emphasizes patient-centered care and research. R...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Immunotherapy for stone disease
Purpose of review In addition to traditional risk factors such as low urine volume or hypercalciuria, emerging data suggest that calcium oxalate (CaOx), one of the most common mineral complexes in the urine, elicits a strong immunologic response. This review highlights those studies and projects how future therapies may be directed for kidney stone prevention. Recent findings Over the last 2 years, several groups have studied the response of the immune system to CaOx crystals using cell culture and animal models. Dominguez et al. found that CaOx crystals were recognized by monocytes through an lipopolysaccharide-media...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Linking 24-h urines to clinical phenotypes: what alternatives does the future bring?
Purpose of review The 24-h urine test is recommended as part of the metabolic evaluation for patients with nephrolithiasis to guide preventive interventions. However, this test may be challenging to interpret and has limits in its predictive ability. In this review, we summarize and discuss the most recent research on the opportunities and challenges for utilizing urinary biomarkers for kidney stone prevention. Recent findings Contemporary studies utilizing the 24-h urine test have improved our understanding of how to better administer testing and interpret test results. Beyond the standard panel of 24-h urine paramet...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Future treatments for hyperoxaluria
This article covers the existing data on endogenous and dietary oxalate and the current targets in these pathways. Summary In the near future, there will likely be therapies targeting both endogenous and dietary oxalate, especially in subsets of kidney stone formers. (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Ureteral stents: the good the bad and the ugly
Purpose of review Ureteral stents are necessary in the routine practice of an urologist. Choosing the correct stent and being aware of the options available will allow urologists to provide the best possible care for patients and value to the healthcare system. This review seeks to educate urologists regarding improvements in stent technology currently available or in development. Recent findings Research from around the world is underway to discover an ideal stent – one that is comfortable for patients, resists infection and encrustation and is affordable for hospital systems. Stent design alterations and stent...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Kidney stones and the opioid epidemic: recent developments and review of the literature
Purpose of review A public health emergency has been declared in response to rising opioid addiction and opioid-related deaths in the United States. As kidney stones have been identified as an important source of initial and repeated opioid exposures, this review seeks to describe the scope of the problem and report relevant alternatives to opioid analgesia for stones. Recent findings Recent literature summarizing the extent of opioid use among those with stones is reviewed. A number of opioid-minimizing strategies and analgesic regimens have been proposed and studied. A review of these modifications and alternatives ...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Editorial: Kidney stone prevention
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Burst wave lithotripsy and acoustic manipulation of stones
Purpose of review Burst wave lithotripsy and ultrasonic propulsion of kidney stones are novel, noninvasive emerging technologies to separately or synergistically fragment and reposition stones in an office setting. The purpose of this review is to discuss the latest refinements in technology, to update on testing of safety and efficacy, and to review future applications. Recent findings Burst wave lithotripsy produced consistent, small passable fragments through transcutaneous applications in a porcine model, while producing minimal injury and clinical trials are now underway. A more efficient ultrasonic propulsion de...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

New devices for kidney stone management
Purpose of review The purpose of this review is to summarize recent developments in the array of devices which are commonly used by urologists in the surgical management of kidney stones. To accomplish this goal, an extensive review of recent endourology literature, conference abstracts, and publicly available documents from manufacturers and the United States Food and Drug Administration was collected and reviewed. Recent findings Recent developments in the holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy include the introduction of pulse modulation. This technique delivers the laser energy in an asymmetric...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Complications after active stone removal
Purpose of review Active stone removal has been entirely revolutionized in the past decades. Smaller instruments, scope and laser technology advancements and novel lithotripter modalities have entirely changed the way urological surgeons treat stones. Nevertheless novel technologies may lead to different and difficult to manage complications. Accurate knowledge of indications, limitations and technical details of these novel modalities can significantly decrease complication rates. The purpose of this review is to provide the most recently acquired knowledge to decrease patient's morbidity after active stone removal. Re...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Lasers for stone treatment: how safe are they?
Purpose of review To update laser lithotripsy advances in regard to new laser types and technologies as well as review contemporary laser safety concerns. Recent findings The high prevalence of urolithiasis and the continuing miniaturization of scopes has encouraged the growth of laser lithotripsy technology. The holmium:yttrium-aluminum-garnet (Ho:YAG) laser has been used for over 20 years in endourology and has been extensively studied. Holmium laser power output is affected by a number of factors, including pulse energy, pulse frequency, and pulse width. Several recent experimental studies suggest that the new dual...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Extracorporeal shock-wave lithotripsy: is it still valid in the era of robotic endourology? Can it be more efficient?
Purpose of review The aim of the article is to evaluate the actual role of extracorporeal shock-wave lithotripsy (ESWL) in the management of urolithiasis based on the new developments of flexible ureterorenoscopy (FURS) and percutaneous nephrolithotomy (PCNL). Recent findings In Western Europe, there is a significant change of techniques used for treatment of renal stones with an increase of FURS and a decrease of ESWL. The reasons for this include the change of indications, technical improvement of the endourologic armamentarium, including robotic assistance. Mostly relevant is the introduction of digital reusable an...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Flexible ureteroscopy: reuse? Or is single use the new direction?
Purpose of review Single-use flexible ureteroscopes (su-fURS) aim at overcoming the main limitations of conventional reusable ureteroscopes in terms of acquisition and maintenance costs, breakages, and reprocessing. However, little data exist to date regarding the superiority of su-fURS at this regard. We aimed to perform a systematic literature review on available su-fURS performance with a focus on clinical data for all articles in the last 10 years. Recent findings To date, more than 10 different su-fURS are available on the market, with different characteristics and performance. Some of these devices have top-leve...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Future of kidney stone management: surgical intervention miniaturization of PCNL: where is the limit?
Purpose of review Miniaturization was the major trend in percutaneous nephrolithotomy in the past 15 years, aiming to lower tract-size-related complication rates while maintaining good stone-free-rates (SFR). Although there is some evidence that 18 Fr Mini-percutaneous lithotomy (PCNL) has comparable efficacy to conventional PCNL and a lower risk of bleeding, it is less clear whether further miniaturization led to an even better safety profile while maintaining good SFR. The present review evaluates the latest results on efficacy, safety, and feasibility of miniaturized techniques 14 Fr or less in PCNL. Recent findings ...
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Evangelos N. Liatsikos and Benjamin K. Canales Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - January 31, 2020 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Prostate-specific membrane antigen-targeted endoradiotherapy in metastatic prostate cancer
Purpose of review In this review, we present an update on the safety and efficacy of prostate-specific membrane antigen (PSMA) radioligand therapy (PRLT) of metastatic castration-resistant prostate cancer (mCRPC). Recent findings Treatment of mCRPC with approved treatment agents leads to a survival advantage. The disease often progresses despite these treatments. PRLT with Lutetium-177 and Actinium-225 labeled with PSMA (LuPSMA and AcPSMA) have recently been shown to be effective and well tolerated for mCRPC treatment. LuPSMA is currently applied in patients who have exhausted approved treatment options or in whom the...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Radical cytoreductive prostatectomy in men with prostate cancer and oligometastatic disease
Purpose of review Local treatment of the primary by either radical prostatectomy or radiation therapy is discussed controversially. The role of cytoreductive radical prostatectomy has been evaluated in few retrospective clinical studies but data of prospective randomized clinical phase-III trials are lacking. It is the purpose of this review to reflect the current knowledge on indication, functional and oncological outcomes of cytoreductive radical prostatectomy to objectively highlight what can be expected from this approach. Recent findings Cytoreductive radical prostatectomy (cRP) is associated with a long overall ...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Complex robotic nephrectomy and inferior vena cava tumor thrombectomy: an evolving landscape
Purpose of review Robotic nephrectomy for complex renal masses and in the setting of inferior vena cava (IVC) tumor thrombus has been shown to be a well tolerated and reproducible surgical option. Recent developments in such procedures will be discussed as they continue to evolve. Recent findings Multiple case series have demonstrated the application of robotic surgery in the management of the most complex renal tumors and for IVC thrombi with acceptable oncologic and perioperative outcomes. Prior to the advent of robotic surgery, massive tumors, contiguous organ invasion, need for lymphadenectomy, and IVC tumor throm...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

Robotic-assisted partial nephrectomy: evolving techniques and expanding considerations
Purpose of review Robotic-assisted partial nephrectomy (RAPN) continues to gain popularity in the setting of nephron-sparing surgery for small renal masses. Although the recent introduction of technological advancements has allowed for expanded roles for RAPN, the optimal techniques and approaches to the procedure remain controversial. Recent findings Of recent interest has been the role of warm ischemia time and its impact on postoperative renal function. Available studies suggest that although warm ischemia time remains an independent and modifiable risk factor for postoperative renal function, the role for ‘z...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

Robot-assisted radical prostatectomy vs. open radical prostatectomy: latest evidences on perioperative, functional and oncological outcomes
Purpose of review Despite increasing use of robotic surgery for radical prostatectomy, the benefit of robotic over open approach on different postoperative outcomes is still under debate. The present review aimed to provide a framework on the latest evidences on outcomes of prostate cancer (PCa) patients treated with robot-assisted radical prostatectomy (RARP) vs. open radical prostatectomy (ORP). Specifically, we focused on postoperative complications, urinary continence and erectile function recovery, PCa recurrence and PCa-related mortality. Recent findings Regarding perioperative outcomes, recent studies confirmed...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

Training in robot-assisted surgery
Purpose of review The aim of this narrative review is to identify the currently available training programs in the field of robotic-assisted surgery. Recent findings The lack of well trained robotic surgeons represents the main obstacle facing robotic surgery. This calls for development of structured robotic training programs in order to improve patient safety and outcomes. Structured curriculum should consist of theoretical training (e-learning, case observation), preclinical simulation-based training (virtual reality simulation, dry and wet lab), clinical modular training, and final evaluation. Tele-mentoring might ...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

3D-printed models and virtual reality as new tools for image-guided robot-assisted nephron-sparing surgery: a systematic review of the newest evidences
Purpose of review Nowadays, kidney cancer surgery has been focusing on a patient-tailored management, expanding the indication to nephron-sparing surgery (NSS). Starting from computer tomography images, 3D models can be created, allowing a never experienced before understanding of surgical anatomy. Once obtained the models can be printed or virtually visualized with the aid to assist the surgeon in preoperative planning and simulation or intraoperative navigation. The aim of this systematic review is to assess the preoperative and intraoperative impact of 3D printed and virtual imaging for robotic NSS. Recent findings ...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

Artificial intelligence and robotic surgery: current perspective and future directions
Purpose of review This review aims to draw a road-map to the use of artificial intelligence in an era of robotic surgery and highlight the challenges inherent to this process. Recent findings Conventional mechanical robots function by transmitting actions of the surgeon's hands to the surgical target through the tremor-filtered movements of surgical instruments. Similarly, the next iteration of surgical robots conform human-initiated actions to a personalized surgical plan leveraging 3D digital segmentation generated prior to surgery. The advancements in cloud computing, big data analytics, and artificial intelligence...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: ROBOTIC SURGERY IN UROLOGY: FACTS AND REALITY: Edited by Firas Abdollah and Alexandre Mottrie Source Type: research

En bloc resection for nonmuscle invasive bladder cancer: review of the recent literature
Purpose of review Conventional transurethral resection of bladder tumor (cTURBT) is the standard approach to the diagnosis and treatment of nonmuscle invasive bladder cancer. However, it suffers from inherent limitations such as insufficient assessment of resection depth and the need for intravesical tumor fragmentation that hampers histopathological evaluation. We summarize recent clinical data on en bloc resection of bladder tumor (ERBT), a method that promises to overcome these limitations. Recent findings The PubMed/Medline databases were searched for reports on ERBT focusing on trends in the last 2 years. ERBT pr...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research

Cytoreductive nephrectomy: does CARMENA (Cancer du Rein Metastatique Nephrectomie et Antiangiogéniques) change everything?
Purpose of review Over the past few years the treatment options for renal cell cancer (RCC) have rapidly evolved. Even in the setting of metastatic disease, a consistent component of treatment in RCC patients has been cytoreductive nephrectomy based on the results of research carried out over a decade ago. Despite huge shifts in systemic treatment modalities, cytoreductive nephrectomy continued to be recommended despite a lack of evidence for its use in metastatic RCC in those patients receiving state-of-the-art therapies. Recent findings To address the lack of evidence, two recent trials [Cancer du Rein Metastatique ...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research

Biological and therapeutic advances in the pursuit of effective immunotherapy for prostate cancer
Purpose of review The successful development of effective cancer immunotherapy, in particular immune checkpoint inhibitors, has changed the treatment paradigm of many tumor types. In light of the limited efficacy of checkpoint inhibitors demonstrated in recent clinical trials in refractory prostate cancer, this review highlights important recent and ongoing studies that are shaping the pursuit of effective immunotherapy for prostate cancer. Recent findings We review two overarching themes with respect to recent studies of prostate cancer immunotherapy: evolving therapeutic strategies and novel biological findings, inc...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research

The changing role of lasers in urologic surgery
Purpose of review To summarize recent publications on the topic of laser in urology and explore new developments which may impact the future role of lasers in surgery. Recent findings Ho: Yttrium-aluminium garnet (YAG) laser with Moses technology allows less retropulsion during a lithotripsy, yet its efficacy needs to be tested in clinical trials. Data on the efficacy of this device for benign prostatic obstruction treatment is also pending. A new promising generation of laser systems – thulium-fiber (Tm-fiber) lasers – has been introduced. Tm-fiber has already been shown to be effective and well tolerated...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research

Frontiers of stone management
Purpose of review The surgical tool-box for urinary stone disease is growing. In this review, we discuss recent developments in the surgical management of urolithiasis, with emphasis on tailoring the management to the individual patient, and attention to the quality of care. Recent findings Shockwave lithotripsy remains a popular noninvasive treatment option for patients, with new data emerging on how to improve treatment outcomes as well as its limitations. Next-generation holmium lasers are expanding the role of dusting techniques for ureteroscopy but further studies are needed to assess safety and clinical outcomes...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research

Promise of PET imaging in prostate cancer: improvement or waste of money?
Purpose of review Prostate cancer is a high prevalence malignancy whose management is a major challenge for clinicians worldwide. Molecular imaging, and in particular PET with computed tomography (PET/CT), is increasingly gaining importance in the work up and management of all prostate cancer patients. PET/CT remains, however, an expensive imaging modality and currently not reimbursed. Recent findings Although other PET tracers are available and have gained institutional recognition from regulatory agencies, prostate-specific membrane agents (PSMA)-based PET/CT tracers have demonstrated the highest sensitivity and spe...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research

Developments in MRI-targeted prostate biopsy
Purpose of review MRI-targeted prostate biopsy may be an attractive alternative to systematic biopsy for diagnosing clinically significant prostate cancer. In this narrative review, we discuss the new developments that have occurred in the advancement of MRI-targeted prostate biopsy, over the past 24 months. Recent findings MRI-targeted biopsy offers enhanced diagnostic accuracy, when compared with the current standard of care of systematic transrectal ultrasound-guided (TRUS) biopsy, by decreasing the overall number of biopsies needed, maintaining or improving significant prostate cancer detection, and reducing the d...
Source: Current Opinion in Urology - December 4, 2019 Category: Urology & Nephrology Tags: BEST OF 2019: Edited by Johannes W. Vieweg and Shahrokh F. Shariat Source Type: research