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 - June 3, 2021 Category: Urology & Nephrology Tags: ERRATUM Source Type: research

Artificial intelligence in prostate histopathology: where are we in 2021?
Purpose of review Artificial intelligence has made an entrance into mainstream applications of daily life but the clinical deployment of artificial intelligence-supported histological analysis is still at infancy. Recent years have seen a surge in technological advance regarding the use of artificial intelligence in pathology, in particular in the diagnosis of prostate cancer. Recent findings We review first impressions of how artificial intelligence impacts the clinical performance of pathologists in the analysis of prostate tissue. Several challenges in the deployment of artificial intelligence remain to be ov...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Radiogenomics in prostate cancer evaluation
Purpose of review Radiogenomics, fusion between radiomics and genomics, represents a new field of research to improve cancer comprehension and evaluation. In this review, we give an overview of radiogenomics and its most recent and relevant applications in prostate cancer management. Recent findings Literature about radiogenomics in prostate cancer emerged last 5 years but remains scarce. Radiogenomics in prostate cancer mainly rely on MRI-based features. Several imaging biomarkers, mostly based on the identification of radiomic features from deep learning studies, have been studied for the prediction of genomic...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Applications of artificial intelligence in prostate cancer imaging
Purpose of review The purpose of this review was to identify the most recent lines of research focusing on the application of artificial intelligence (AI) in the diagnosis and staging of prostate cancer (PCa) with imaging. Recent findings The majority of studies focused on the improvement in the interpretation of bi-parametric and multiparametric magnetic resonance imaging, and in the planning of image guided biopsy. These initial studies showed that AI methods based on convolutional neural networks could achieve a diagnostic performance close to that of radiologists. In addition, these methods could improve seg...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Kidney cancer management 3.0: can artificial intelligence make us better?
Purpose of review Artificial intelligence holds tremendous potential for disrupting clinical medicine. Here we review the current role of artificial intelligence in the kidney cancer space. Recent findings Machine learning and deep learning algorithms have been developed using information extracted from radiomic, histopathologic, and genomic datasets of patients with renal masses. Summary Although artificial intelligence applications in medicine are still in their infancy, they already hold immediate promise to improve accuracy of renal mass characterization, grade, and prognostication. As algorithms beco...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Artificial intelligence in bladder cancer prognosis: a pathway for personalized medicine
Purpose of review This review aims to provide an update of the results of studies published in the last 2 years involving the use of artificial intelligence in bladder cancer (BCa) prognosis. Recent findings Recently, many studies evaluated various artificial intelligence models to predict BCa evolution using either deep learning or machine learning. Many trials evidenced a better prediction of recurrence-free survival and overall survival for muscle invasive BCa (MIBC) for deep learning-based models compared with clinical stages. Improvements in imaging associated with the development of deep learning neural ne...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

The use of artificial intelligence for the diagnosis of bladder cancer: a review and perspectives
Purpose of review White light cystoscopy is the current standard for primary diagnosis and surveillance of bladder cancer. However, cancer changes can be subtle and may be easily missed. With the advancement of deep learning (DL), image recognition by artificial intelligence (AI) proves a high accuracy for image-based diagnosis. AI can be a solution to enhance bladder cancer diagnosis on cystoscopy. Recent findings An algorithm that classifies cystoscopic images into normal and tumour images is essential for AI cystoscopy. To develop this AI-based system requires a training dataset, an appropriate type of DL alg...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Artificial intelligence in stone disease
Purpose of review Artificial intelligence (AI) is the ability of a machine, or computer, to simulate intelligent behavior. In medicine, the use of large datasets enables a computer to learn how to perform cognitive tasks, thereby facilitating medical decision-making. This review aims to describe advancements in AI in stone disease to improve diagnostic accuracy in determining stone composition, to predict outcomes of surgical procedures or watchful waiting and ultimately to optimize treatment choices for patients Recent findings AI algorithms show high accuracy in different realms including stone detection and i...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Artificial intelligence in functional urology: how it may shape the future
Purpose of review The aim of the present manuscript is to provide an overview on the current state of artificial intelligence (AI) tools in either decision making, diagnosis, treatment options, or outcome prediction in functional urology. Recent findings Several recent studies have shed light on the promising potential of AI in functional urology to investigate lower urinary tract dysfunction pathophysiology but also as a diagnostic tool by enhancing the existing evaluations such as dynamic magnetic resonance imaging or urodynamics. AI may also improve surgical education and training because of its automated per...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

How the use of the artificial intelligence could improve surgical skills in urology: state of the art and future perspectives
This article reviews advances in the use of machine learning and artificial intelligence for improvements of surgical skills in urology. Recent findings Six studies have been published, which met the inclusion criteria. All articles assessed the application of artificial intelligence in improving surgical training. Different approaches were taken, such as using machine learning to identify and classify suturing gestures, creating automated objective evaluation reports, and determining surgical technical skill levels to predict clinical outcomes. The articles illustrated the continuously growing role of artificial in...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Future artificial intelligence tools and perspectives in medicine
Purpose of review Artificial intelligence has become popular in medical applications, specifically as a clinical support tool for computer-aided diagnosis. These tools are typically employed on medical data (i.e., image, molecular data, clinical variables, etc.) and used the statistical and machine-learning methods to measure the model performance. In this review, we summarized and discussed the most recent radiomic pipeline used for clinical analysis. Recent findings Currently, limited management of cancers benefits from artificial intelligence, mostly related to a computer-aided diagnosis that avoids a biopsy ...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Editorial: Artificial intelligence will shape the future of urology but good things come to those who wait
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: ARTIFICIAL INTELLIGENCE IN UROLOGY: Edited by Karim Bensalah and Benjamin Pradere Source Type: research

Acute kidney injury in COVID-19: are kidneys the target or just collateral damage? A comprehensive assessment of viral RNA and AKI rate in patients with COVID-19
Purpose of review To investigate the possible effects of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) on kidney function and assess the rate of viral ribonucleic acid (RNA) shedding/detection in urine. Recent findings Most of the research on the topic suggests that for the moment our ability to estimate whether SARS-CoV-2 is a direct causative agent in acute kidney injury (AKI) or whether it has a cytokine storm effect is limited. During our prospective assessment of 333 patients with COronaVIrus Disease 2019 (COVID-19) it was found that frequency of AKI of 9.6% (32 cases). Despite previo...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Contemporary patterns of presentation, diagnostics and management of upper tract urothelial cancer in 101 centres: the Clinical Research Office of the Endourological Society Global upper tract urothelial carcinoma registry
Purpose of review To assess patterns of presentation, diagnostics and treatment in patients with upper tract urothelial carcinoma (UTUC), a multicentre registry was launched. Clinical data of UTUC patients were prospectively collected over a 5-year period. Recent findings Data from 2380 patients were included from 2014 to 2019 (101 centres in 29 countries). Patients were predominantly male (70.5%) and 53.3% were past or present smokers. The majority of patients (58.1%) were evaluated because of symptoms, mainly macroscopic hematuria. Computed tomography (CT) was the most common performed imaging modality (90.5%)...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Association between male infertility and prostate cancer: a systematic review and meta-analysis
Purpose of review Male infertility has been shown to be associated with different maladies. The present systematic review and meta-analysis aimed to summarize the available evidence on the association between male infertility or childlessness and prostate cancer. Recent findings The PubMed, Web of Science, and Scopus databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Studies were deemed eligible if they compared males with known infertility or childlessness to the control group including fertile males with regards to the diagnosis of prostate ca...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

COVID-19 crisis and minimally invasive surgery: a narrative review on intraoperative aerosol viral transmission and their impact on guidelines and clinical practice in Austria
Purpose of review The purpose of this review is to evaluate the risk of intraoperative aerosol viral transmission and the impact of updated COVID-19 guidelines on minimally invasive surgery (MIS) in Austria. Recent findings The current literature does not support the risk of intraoperative viral transmission nor does it suggest a harm of minimally invasive procedures in the context of the COVID-19 pandemic. However, medical societies mostly adopted a precautionary approach with a focus on protective measures. Austrian surgeons considered MIS safe during the pandemic and Austria managed to keep the initial outbre...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Adverse events of systemic immune-based combination therapies in the first-line treatment of patients with metastatic renal cell carcinoma: systematic review and network meta-analysis
Purpose of review To compare the safety profiles of systemic immune checkpoint inhibitor-based combination therapies that were evaluated in the first-line setting of the management of patients with advanced or metastatic renal cell carcinoma (mRCC). Recent findings Six phase III randomized control trials comparing first-line immune-based combination therapies to sunitinib in previously untreated patients with mRCC. Network meta-analyses were conducted to compare treatment-related adverse events (TRAEs), treatment discontinuation, and treatment-related mortality. Summary Lenvatinib plus pembrolizumab was a...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Novel transurethral resection technologies and training modalities in the management of nonmuscle invasive bladder cancer: a comprehensive review
Purpose of review Conventional transurethral resection (TURBT) with tumor fragmentation is the primary step in the surgical treatment of nonmuscle invasive bladder cancer. Recently, new surgical techniques and training modalities have emerged with the aim to overcome short-comings of TURBT and improve oncologic outcomes. In this review, we provide a comprehensive update of recent techniques/techniques that aim to improve upon conventional TURBT and beyond. Recent findings A systemic approach during conventional TURBT that features the use of a surgical checklist has been shown to improve recurrence-free survival...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

The prognostic value of sarcopenia in patients with prostate cancer: a systematic review
Purpose of review Sarcopenia is known to affect perioperative and oncologic outcomes in patients with different urological malignancies. Nevertheless, the use of pretreatment sarcopenia as a predictor of clinical outcomes in patients with prostate cancer is still poorly studied. Therefore, we aimed to conduct a systematic review summarizing the available evidence and identifying the prognostic value of sarcopenia in prostate cancer patients. Recent findings Sarcopenia was not predictive of biochemical recurrence in patients treated with radical prostatectomy. However, it was associated with worse long-term survi...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Health-related quality of life in bladder cancer patients: bladder cancer-specific instruments and domains. Part 2
Purpose of review Several instruments have been designed to evaluate health-related quality of life (HRQoL) in patients with bladder cancer (BC). However, they vary in purpose, domains, and quality. To identify QoL instruments that have been validated for BC patients and to critically assess their domains and limitations. Recent findings Of the 11 instruments identified, seven have been externally validated. Of these, four can be used across all disease states; two are available for QoL assessment in patients with non-muscle invasive bladder cancer (NMIBC); and the European Organisation for Research and Treatmen...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Health-related quality of life in bladder cancer patients: general and cancer-specific instruments. Part 1
Purpose of review Although survival outcomes are the primary outcomes to determine the effectiveness of treatment options, quality of life (QoL) is gaining in importance in addition to classic oncological outcomes. The present review aims to state and critically assess the challenges in health-related QoL (HRQoL) assessment especially in bladder cancer (BC) patients. Recent findings General QoL-instruments do not address concerns specific to cancer patients or BC patients. Domains, such as sexual functioning, embarrassment, self-consciousness, psychological distress, and urinary incontinence, are not adequately ...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Quality indicators for the management of high-risk upper tract urothelial carcinoma requiring radical nephroureterectomy
Purpose of review The purpose of this article was to identify quality indicators for an optimized management of high-risk upper tract urothelial carcinoma (UTUC) requiring radical nephroureterectomy (RNU). Recent findings RNU with bladder cuff resection is the standard treatment of high-risk UTUC. For the bladder cuff resection, two main approaches are accepted: transvesical and extravesical. Lymph node dissection following a dedicated template should be performed in all high-risk patients undergoing RNU as it improves tumour staging and possibly survival. Postoperative bladder instillation of single-dose chemot...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Rising significance of antibiotic stewardship in urology and urinary tract infections – a rapid review
Purpose of review To give an overview of the significance as well as recent developments in antibiotic stewardship (ABS) in urology and for the treatment of urinary tract infections (UTI). This rapid review is focused on recent publications during the past 18 months. Recent findings Despite the evidence to support the use of ABS interventions in the treatment of UTIs, there remains considerable inappropriate use of antibiotics, up to 68%, especially concerning the treatment of asymptomatic bacteriuria and the overuse of fluoroquinolones. Emerging evidence indicate that ABS programs can improve patient outcome ...
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: HEALTH CARE FACTORS IN UROLOGY: Edited by Shahrokh F. Shariat and Mohammed Abufaraj Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - June 3, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

What is next in second- and later-line treatment of metastatic renal cell carcinoma? review of the recent literature
Purpose of review The current treatment landscape of metastatic renal cell carcinoma has changed dramatically from the dominance of single-agent tyrosine kinase inhibitor (TKI) therapy to immune-checkpoint inhibitor (ICI)-based combinations in recent years. However, the optimal subsequent therapy remains ill-defined owing to the novelty of this approach. Recent findings Treatment with TKIs after failure of single or dual ICI therapies may result in robust clinical efficacy. Nonetheless, there is a trend toward lower efficacy of TKIs after previous ICI–TKI combination therapy. Currently, tivozanib is the on...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Dual immune check point blockade or immune check point-tyrosine kinase inhibitor combination: as a first-line treatment in metastatic renal cell carcinoma?
Purpose of review To discuss treatment decisions in the first-line setting of metastatic renal cell carcinoma (mRCC). Recent findings Immune check point inhibitor (ICI) combinations have replaced sunitinib as the standard of care in the first-line treatment of mRCC. Dual ICI treatment with nivolumab and ipilimumab was shown to significantly improve overall survival and objective response rates. Similarly, the ICI–tyrosine kinase inhibitor combinations pembrolizumab and axitinib and nivolumab and cabozantinib have demonstrated superiority in terms of overall survival, objective response rates and progressio...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Perioperative therapy in renal cancer in the era of immune checkpoint inhibitor therapy
Purpose of review Immune checkpoint inhibitor (ICI) combination therapy has revolutionized therapy of metastatic renal cancer. The success of immunotherapy has renewed an interest to study these agents in adjuvant and neoadjuvant settings and prior to cytoreductive nephrectomy. This narrative review will give an overview of ongoing trials and early translational research outcomes. Recent findings In nonmetastatic renal cell carcinoma (RCC), five phase 3 adjuvant and neoadjuvant trials with ICI monotherapy or combinations are ongoing with atezolizumab (IMmotion 010; NCT03024996), pembrolizumab (KEYNOTE-564; NCT03...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

How to improve outcome in nephron-sparing surgery: the impact of new techniques
Purpose of review Nephron-sparing partial nephrectomy is the state of the art for localized small renal mass and it is gaining attention also for more advanced cases. In the present narrative review, we discuss the new developments that have occurred in the advancement of this approach over the past few years. Recent findings Off-clamp, selective/superselective clamp and early-unclamping techniques are safe and feasible approaches, with potentially superior functional outcomes, and noninferior complications rate and oncological outcomes, when compared with main artery clamping. Renorrhaphy must preserve the phys...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Targeted PET/CT imaging for clear cell renal cell carcinoma with radiolabeled antibodies: recent developments using girentuximab
Purpose of review Conventional imaging is unable to differentiate clear cell renal cell carcinoma (ccRCC) from other more indolent and benign renal tumors. Positron emission tomography/computed tomography (PET/CT) using radiolabeled antibodies may aid in detecting both localized and metastatic ccRCC. The purpose of this review is to summarize recent literature regarding the use of radiolabeled antibodies for imaging of ccRCC. Recent findings Two recent studies evaluated the use of radiolabeled anticarbonic anhydrase IX antibody girentuximab for the imaging of ccRCC. PET/CT with 89zirconium-labeled girentuximab (...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Metastatic nonclear renal cell carcinoma current review in evolving treatment strategies
Purpose of review Renal cell carcinoma (RCC) is the 6th most often diagnosed cancer in men and the 10th in women. Nearly 75% of the renal cancer cases are clear cell histologic subtype, whereas nonclear cell histologies represent the remaining 25%. Treatment options for clear renal type are well established. However, as nonclear RCC represents a heterogenous and less frequent group. Current treatment options for these tumors are limited and mostly based on evidence derived from small phase II clinical trials. The present review aims to provide an update of the available treatment options for nonclear RCC. Recent fin...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Individualizing renal cell carcinoma treatment through biomarkers discovery in the era of immune checkpoint inhibitors: where do we stand?
Purpose of review The treatment landscape of metastatic renal cell carcinoma has greatly evolved over the past fifteen years, leading to a significant improvement in the outcome of our patients. However, there is still an urgent need for predictive biomarkers that could guide our treatment selection, especially in the present era of immune-based treatments. Recent findings A number of putative biomarkers of immunotherapy activity have been proposed over the past few years, including PD-L1 immunohistochemical expression, tumor mutational burden, neoantigens load, insertions and deletions, complex gene signatures,...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Renal cell carcinoma pathology in 2021: ‘new need for renal cancer immune profiling’
Purpose of review The aim of this review is to outline characteristics of the renal cell carcinoma (RCC) tumor immune microenvironment (TIME), the potential impact of tumor intrinsic alterations on the TIME and the value of metastatic tissue assessment in this context. Recent findings According to the latest European Association of Urology, European Society for Medical Oncology and National Comprehensive Cancer Network guidelines immune checkpoint inhibition represents a new core treatment strategy in advanced clear cell RCC (ccRCC). Despite its success, the prognosis of many RCC patients remains unsatisfactory ...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Editorial: Standard and future in the treatment of renal cell carcinoma
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: KIDNEY CANCER: Edited by Jens Bedke, Axel Bex and Manuela Schmidinger Source Type: research

Surgical intervention in patients with urothelial carcinoma of the bladder and lymph node metastasis
Purpose of review To systematically review the most recent evidence on the role of surgery in patients with urothelial carcinoma of bladder and lymph node metastasis. Recent findings Patients with urothelial carcinoma of bladder and lymph node metastasis have a poor prognosis. The mainstay treatment for these patients is systemic chemotherapy. However, slowly growing body of literature suggests that multimodal therapy comprised of radical cystectomy, lymph node dissection, and perioperative chemotherapy is more effective than either chemotherapy or surgery alone. The timing of chemotherapy, whether preoperative ...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Salvage therapy for localized recurrences of penile cancer
Purpose of review To review the current literature and guidelines regarding salvage therapy for local and regional recurrence of primary penile cancer. Recent findings While invasive surgical management has not significantly changed, penile sparing treatments (PSTs) may have a promising role in the management of local recurrence. Penile sparing surgeries do appear to have higher rates of recurrence. However, the overall survival rate is comparable to that of partial and total penectomies. Additionally, a combination of therapies may have a more profound effect on management of penile cancer. Summary Clini...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Salvage management of patients with relapsing testicular germ cell tumors
Purpose of review This review aims to summarize the latest evidence of medical and surgical treatment options for patients with relapsing testicular germ cell tumors. Recent findings Depending on International Germ Cell Cancer Classification Group risk classification 10–50% of patients with metastatic TGCT develop relapse which needs further multimodality treatment. With regard to therapy, early relapses are stratified according to their prognostic risk profile which results in a 3-year overall survival between 6% in the very high to 77% in the very low risk group. Prognostic risk score dictates systemic t...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Oligometastatic prostatic cancer recurrence: role of salvage lymph node dissection (sLND) and radiation therapy-stereotactic body radiation therapy (RT-SBRT)
Purpose of review Metastases directed therapy (MDT) is an increasingly utilized modality in patients with oligometastatic prostate cancer (OMPC) recurrence. The purpose of our review is to discuss the recent literature on the safety and oncologic outcomes of this treatment approach. Recent findings Metastases directed therapy, in particular, stereotactic body radiation therapy (SBRT) and salvage lymph node dissection (sLND), has shown promising efficacy in patients with OMPC. Many case series report favorable outcomes with MDT as compared to hormonal deprivation therapy alone or surveillance. Of the few case ser...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Salvage radical prostatectomy after local radiotherapy in prostate cancer
Purpose of review Salvage surgeries are rarely offered and performed in prostate cancer except for isolated lymph node metastases. Meanwhile, data are sufficient that salvage radical prostatectomy is recommended by the guidelines. In the following review, we focus on different treatment strategies comparing open and DaVinci laparoscopic approach with regard to functional and oncologic outcome. Of further interest are palliative surgeries. Recent findings Salvage radical prostatectomy is mainly performed in high volume centres. Data are increasing on minimal invasive surgery, although data on functional outcome a...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Salvage ablation for locally recurrent prostate cancer
Purpose of review This review aims to summarize the latest evidence for the use of salvage ablation of localized prostate cancer recurrences after primary therapy radiotherapy or prostatectomy. Recent findings Savage ablation represents a treatment option in select patients with localized recurrences following primary therapy of prostate cancer. Following radiotherapy, salvage cryotherapy and high-intensity focused ultrasound (HIFU) demonstrate encouraging oncologic outcomes. Biochemical recurrence-free survival ranged from 71% at 2 years to 44.2% at 10 years for cryotherapy and from 51% at 5 years to 28.7...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

The current landscape of salvage therapies for patients with bacillus Calmette-Guérin unresponsive nonmuscle invasive bladder cancer
Purpose of review Although radical cystectomy represents the gold standard treatment for patients with high-risk nonmuscle invasive bladder cancer (NMIBC) whose disease does not respond to bacillus Calmette-Guérin (BCG), many patients are unable or unwilling to undergo surgery. The need remains for effective bladder-preserving therapies. This review aims to describe existing treatments, contemporary research in this field and ongoing trials of salvage therapies for patients with BCG-unresponsive NMIBC. Recent findings Intravesical chemotherapy has been utilized frequently in this setting. Emerging data on...
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Editorial: Salvage therapy in uro-oncology
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: SALVAGE THERAPY IN UROLOGY ONCOLOGY: Edited by R. Jeffrey Karnes and Axel Heidenreich Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - April 6, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Modern surgical strategies in the management of complex ureteral strictures
Purpose of review The purpose of this article is to outline the various therapeutic options of ureteral strictures. Recent findings Ureteral strictures with consecutive hydronephrosis can be due to endourological and surgical procedures, inflammatory processes, radiation therapy as well as spontaneous passage of ureteral calculi. When planning surgical correction, stricture length, anatomical location as well as patients’ characteristics like age, comorbidities and previous treatment in the peritoneal cavity, retroperitoneum or pelvis should be taken into consideration. Treatment options include not only s...
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Immunotherapy in Bacillus Calmette–Guerin (BCG) unresponsive nonmuscle invasive bladder cancer
Purpose of review A number of promising therapies for Bacillus Calmette–Guerin (BCG) unresponsive nonmuscle invasive bladder cancer (NMIBC) are in the pipeline. In this review, we discuss the history of immunotherapy for the treatment of NMIBC and future developments, focusing on novel intravesical treatments. Recent findings The term BCG unresponsive NMIBC encompasses patients with both BCG refractory and BCG relapsing disease. This definition was adopted to standardize inclusion criteria for patients enrolling in clinical trials in this setting. A host of intravesical immuno-oncologic therapies that incl...
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Autonomous robots: a new reality in healthcare? A project by European Association of Urology-Young Academic Urologist group
Purpose of review Artificial intelligence appears as a potential revolution in the general process of medical training, disease diagnosis and treatment. A novel disruptive technology of the 21st century will be ‘learner’ robots from artificial intelligence systems able to use all the combination of the available knowledge in medical repositories to give the best standard of care. Recent findings The autonomy level of robots depends on three factors: the complexity of the task; the environment in which the robot operates, and the required level of human–robot interaction. Autonomous robots in he...
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

The microbiome in urinary tract infections in children – an update
Purpose of review Urinary tract infection (UTI) is one of the most common pediatric infections worldwide. Recently introduced 16S rRNA sequencing allows detailed identification of bacteria involved in UTI on a species-based level. The urogenital microbiome in children is scarcely investigated, with underlying conditions differing from adults. Improvement in diagnostic and therapeutic approaches can help to minimize unnecessary antibiotic treatments, thereby protecting the physiological microbiome. Recent findings Healthy bladders of children display a distinct microbiome than those of adults. UTI is characterize...
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Beyond botulinum neurotoxin A for chemodenervation of the bladder
Purpose of review Botulinum neurotoxin A (BoNT/A), or Botox, is a popular option for overactive bladder (OAB) and neurogenic bladder (NGB) with or without incontinence. This review aims to discuss the clinical outcomes of BoNT in adult and pediatric bladder conditions, and introduces the potential benefit of novel, engineered neurotoxins beyond BoNT/A. Recent findings A large volume of evidence supports the use of Botox for OAB (to reduce urgency, frequency and incontinence episodes), and for NGB (to decrease incontinence and improve bladder capacity and detrusor pressures). Botox is now also Food & Drug Adm...
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Simulation in urology: quo vadis
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: BRIEF SUMMARY Source Type: research

Diagnosis and therapeutic strategies for nutcracker syndrome
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: BRIEF SUMMARY Source Type: research

Innovations in urolithiasis management
Purpose of review This review provides a forecast about ongoing developments in the management of urolithiasis with a potential to challenge the current standard of care. We therefore emphasized innovative technology, which might be considered still experimental in the daily clinic or needs further clinical validation, but harbors the great potential to become a game changer for future stone management. Recent findings Especially in the endoscopic stone treatment, we observed a multitude of groundbreaking technical innovations, which changed our treatment algorithms over the last decades. Some of this technology...
Source: Current Opinion in Urology - February 4, 2021 Category: Urology & Nephrology Tags: FUTURE OF KIDNEY STONE MANAGEMENT: Edited by Bhaskar K. Somani and Khurshid R. Ghani Source Type: research