Recent developments in the diagnosis and management of N1 penile cancer
This article presents a critical review of the current literature to provide a brief update on the contemporary advances in diagnosing and managing N1 penile cancer. Recent findings Penile squamous cell carcinoma (pSCC) has evolved from being an orphan field for cancer innovation. Advances in the understanding tumour biology have enabled sophisticated diagnostics and predictive modelling to better characterize inguinal disease. Minimally invasive inguinal lymph node dissection is emerging as a technique that reduces morbidity while maintaining oncological safety. Furthermore, robust clinical trials are underway ,whi...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Diagnostic evaluation for adrenal tumors – What does the urologist need to know about endocrine metabolic work up?
This article reviews which diagnostics are necessary to identify adrenal masses requiring treatment. Recent findings Delayed hormonal assessment is not uncommon and associated with delayed treatment. The endocrine work up is guided by data from prospective and retrospective observational studies. Adrenal tumors include a wide spectrum of diseases and as a principle, most patients require biochemical testing to select the appropriate treatment. Summary The most important factor for the outcome in the management of adrenal masses is, beside the exclusion of malignancy, a structured evaluation of the patients en...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Treatment of adrenocortical carcinoma: oncological and endocrine outcomes
Purpose of review Adrenocortical carcinoma (ACC) is a rare, aggressive disease with a paucity of data and great variability between published studies regarding its treatment. This review provides information on current clinical management and oncological and endocrine outcomes. Recent findings Complete surgical resection is the only potentially curative treatment for adrenocortical carcinoma (ACC). Adjuvant mitotane treatment is recommended in patients with favourable/intermediate prognosis. As part of the endocrine follow-up, steroid hormones and thyroid hormones may be decreased or increased and may need to be...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: SPECIAL COMMENTARIES Source Type: research

Optimizing outcomes for men with severe infertility
Purpose of review To evaluate recent evidence related to optimizing outcomes for men with severe infertility, including effect of ejaculatory abstinence interval on semen parameters and assisted reproductive technology (ART) outcomes, and impact of cryopreservation on surgically retrieved testicular sperm obtained from men with nonobstructive azoospermia (also referred to as azoospermia due to spermatogenic dysfunction). Recent findings Recent evidence strongly suggests that a short abstinence interval improves sperm motility and ART outcomes. Similarly, recent studies have concluded that using fresh vs. frozen ...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

Modern surgical treatment of azoospermia
Purpose of review To review noteworthy research from the last 2 years on surgical management of azoospermia. Recent findings The recommended treatments for nonobstructive and obstructive azoospermia have not appreciably changed. However, recent level-1 evidence has reinforced superiority of micro-dissection testicular sperm extraction over sperm aspiration in men with nonobstructive azoospermia, and several studies have identified genetic and other clinical factors that may aid in selecting candidates for testicular sperm extraction. Machine learning technology has shown promise as a decision support system for ...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

The ‘-ics’ of male reproduction: genomics, epigenetics, proteomics, metabolomics, and microbiomics
Purpose of review To review the most current findings, from the past 2 years, in various ‘-ics’ fields in male infertility, with a specific focus on nonobstructive azoospermia, the most severe form, and varicocele, the most common correctable cause of male infertility. Recent findings Recent studies confirm previously identified causes and identify previously unknown genetic mutations as causes for nonobstructive azoospermia and varicocele. Summary Infertility is a common problem for couples with approximately half of cases attributable to male factor infertility. Although advances in assisted reprodu...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

Advanced sperm tests and impact on clinical male factor management
Purpose of review Although semen analysis remains a cornerstone of male fertility evaluation, conventional semen analysis parameters do not assess for DNA integrity or functional capacity of sperm. Sperm DNA fragmentation (SDF) and sperm aneuploidy tests have been utilized as adjunct tools to distinguish fertile and infertile men and predict pregnancy outcomes. This review serves as an update on indications and utility of advanced sperm tests, as well as associated controversies and limitations. Recent findings Elevated SDF is associated with prolonged time to pregnancy, lower chance of spontaneous pregnancy, an...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

Evolution of the basic semen analysis and processing sperm
Purpose of review The sixth edition of the World Health Organization (WHO) laboratory manual for the examination and processing of human semen was recently published with specific step-by-step instructions for semen evaluation and sperm processing. Point-of-care (POC) testing for semen evaluation and microfluidics for sperm processing are rapidly evolving technologies that could impact how we evaluate and process sperm. Understanding the updated manual in the context of these novel technologies is important. Recent findings Proper standardization of semen evaluation and sperm processing will allow for consistent...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

Medical management of male infertility: now and future
Purpose of review Medical therapy for idiopathic male infertility has historically been empiric and based on small observational studies rather than larger well designed clinical trials. This review is timely and relevant because of the recent publication of several studies that are less susceptible to bias because of being placebo-controlled and more highly powered. Recent findings The largest proportion of recent publications covered antioxidants, with eight randomized controlled trials (RCTs) included in this review. The Males, Antioxidants, and Infertility (MOXI) trial is of particular interest, being a larg...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

Counseling for the man with severe male infertility
Purpose of review This review summarize the proper counseling for men with severe male factor infertility. Recent findings Men who are experiencing infertility should have a semen analysis, the results of which may imply additional investigations, including genetic and hormonal. Moreover, possible modifiable factors that may harm men's reproductive health should be carefully evaluated. Finally, different treatment options are available. Summary Approximately 15% of couples struggle with infertility. Complete evaluations of both men and women are required to determine the etiology of infertility and determ...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

The contemporary role of varicocele repair: why operate when in-vitro fertilization results are so good?
Purpose of review A male factor is either the primary cause or is contributory in at least half of all couples with infertility. Currently, many male factor problems may be disregarded, as reproductive technology has advanced so much that in-vitro fertilization (IVF)/Intracytoplasmic sperm injection (ICSI) allows the use of even a single sperm to achieve pregnancy. Recent findings Varicocele is the most commonly diagnosed correctable cause. Microsurgical repair is considered the gold standard for repair. Research has shown that varicocele repair can impact the outcome of reproductive management and upgrade male ...
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: FERTILITY AND REPRODUCTIVE MEDICINE CENTER: Edited by Peter N. Schlegel and Craig Niederberger Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Urology)
Source: Current Opinion in Urology - December 1, 2022 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Histological patterns, subtypes and aspects of prostate cancer: different aspects, different outcomes
Purpose of review The most common prostatic cancers (PCa) are acinary adenocarcinomas. Histological subtypes have been variably defined. The purpose of this review is to discuss unusual histological patterns and subtypes of acinar adenocarcinoma, as well as other types of PCa and their prognostic and therapeutic relevance. Recent findings The new term ‘subtype’ for morphologically defined tumor entities replaced the term ‘variant’ in the new 2022 classification of the WHO to allow for clear terminological distinction from genetic variants. The 2022 WHO classification mentions prostatic intraepithelial ne...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: SPECIAL COMMENTARY Source Type: research

The role of surgery for loco-regional and advanced urological cancers
Purpose of review There is a general misconception that surgery is the antithesis of palliation. However, symptom mitigation, the basic tenet of palliative interventions, can be achieved by invasive procedures. Surgical care, thus, plays an important role in palliative oncology, alongside radiation and systemic therapy. There is global movement to improve palliation in oncology, and thus it is timely to evaluate the role of surgical interventions can play in this setting. Recent findings Many of the surgical interventions done with palliative intent were first established as curative options. Most studies looked...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: THE ROLE OF SURGERY FOR LOCO-REGIONAL AND ADVANCED UROLOGICAL CANCERS: Edited by Declan Murphy and Derya Tilki Source Type: research

Metastasectomy in renal cell carcinoma: where are we now?
This article highlights key variables to consider when contemplating metastasectomy for RCC and provide a narrative review on the evidence for metastasectomy in these patients. Recent findings Tumour subtype is associated with differing patterns of recurrence. Patients with single or few metastatic sites have better outcomes, and those with greater time interval from initial nephrectomy. Local recurrence is particularly amenable to minimally invasive surgical resection and is oncologically sound. Very well selected cases of liver or brain metastases may benefit from metastectomy, although lung and endocrine metastas...
Source: Current Opinion in Urology - September 29, 2022 Category: Urology & Nephrology Tags: THE ROLE OF SURGERY FOR LOCO-REGIONAL AND ADVANCED UROLOGICAL CANCERS: Edited by Declan Murphy and Derya Tilki Source Type: research