CURRENT OPINION IN UROLOGY

Comparison of surgical effectiveness: kidney sparing surgery for upper tract urothelial carcinoma
Schuil HW, Figaroa OJA, Baard J, Lifshitz DA, Jamaludin FS and Kamphuis GM
This review provides an overview of the recent publications on kidney-sparing-surgery (KSS) for upper tract urothelial carcinoma (UTUC), an alternative to radical nephroureterectomy (RNU) for an increasing number of indications.
Editorial introductions
A narrative review on the performance and outcomes of penile and scrotal surgery in the ambulatory setting
Shah J, Fidel MG, Almuhanna AM, Bal DS and Patel P
Following the COVID-19 pandemic, surgical wait times have surged, creating a backlog in elective urological procedures. This review aims to address the need to explore ambulatory care for penile and scrotal surgeries, which can offer benefits by shifting these procedures away from traditional inpatient settings.
Urinary incontinence in older adults - enhancing care and future research
Zimmern P and Rubin CD
Non-invasive central nervous system stimulation to improve bladder and pelvic floor function in the aging population
Chen A, Hwang K and Khavari R
The literature was reviewed for all noninvasive central nervous system (CNS) stimulation techniques, which includes transcranial brain or trans-spinal stimulation, in the aging population. Given the rising ubiquity of this technology, noninvasive nature, and low side-effect profile reported, this technology can have a big impact on the aging population. As patients afflicted with neurogenic disorders are living longer lives, a special emphasis is placed on the aging neurogenic population.
The role of MRI in muscle-invasive bladder cancer: an update from the last two years
Pastorino GL, Mercinelli C and Necchi A
Muscle invasive bladder cancer (MIBC) is aggressive and requires radical cystectomy and neoadjuvant therapy, yet over 40% of patients face recurrence. The loss of the bladder also significantly reduces quality of life. Accurate staging, crucial for treatment decisions, is typically done through transurethral resection (TURBT), but inconsistencies in pathology affect diagnosis in 25% of cases. MRI is the most precise imaging method for evaluating local tumor invasiveness. This review discusses recent advances in MRI for staging MIBC and predicting responses to neoadjuvant therapy.
Gaps in knowledge and recurrent urinary tract infections in women
Zimmern P
The focus of this review is to present recent literature and gaps in knowledge (GIKs) surrounding the current and future treatment and prevention of uncomplicated recurrent urinary tract infections (rUTIs) in women.
Gold standard nephroureterectomy, chemoprophylaxis and surveillance in upper tract urothelial carcinoma
Basile G, Bandini M, Li R, Poch MA, Necchi A and Spiess PE
The purpose of this review is to summarize the most recent evidence on surgical management, strategies to reduce tumor recurrence, and surveillance regimens in patients diagnosed with upper tract urothelial carcinoma (UTUC) and elected for radical treatment.
Perioperative systemic therapy, current paradigm and ongoing clinical trials in upper tract urothelial cancer
Bhanvadia RR, Khene ZE and Margulis V
To provide of comprehensive overview of existing and future paradigms for perioperative systemic therapy in the treatment of upper tract urothelial carcinoma.
Novel intravesical therapies and delivery systems for the management of bladder cancer
Grobet-Jeandin E, Rouprêt M and Seisen T
Bladder cancer is a substantial burden for public health worldwide. A risk-adapted treatment strategy is required for non muscle-invasive (NMIBC) and muscle-invasive bladder cancer (MIBC). To date, treatment includes surgery with or without peri-operative local or systemic treatment. The aim of this review was to explore novel intravesical therapies and delivery systems emerging in NMIBC and MIBC.
Medical therapy for male infertility
Pozzi E, Corsini C and Salonia A
To provide up-to-date evidence and clinical guidance on the role of medical therapy in the context of hormonal imbalances affecting human spermatogenesis.
Guiding treatment decisions in renal cell carcinoma: the role of biomarkers and clinical factors
Huebner-Resch I and Schmidinger M
Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for metastatic renal cell carcinoma (mRCC), significantly improving overall survival and achieving durable responses. This review is timely due to the increasing number of ICI-based regimens now considered standard care for RCC. There is an urgent need to identify reliable biomarkers that can predict therapeutic responses and resistance, a key challenge in current research.
The biologic landscape and therapeutic implications of upper tract urothelial cancer
Vlachou E, Hoffman-Censits J and Singla N
Management of upper tract urothelial cancer (UTUC) has been largely extrapolated from bladder cancer due to its rarity; however, unique biological and clinical differences between UTUC and bladder cancer have been uncovered. The purpose of this review is to present the current therapeutic landscape of UTUC with an emphasis on biologically driven rationale.
Future directions in transmasculine genital gender-affirming surgery: tissue substitutes and transplant
Xu AJ, Zeki JA, Khouri J, Mishra K and Gupta S
The present study reviews contemporary literature focused on transplantation and tissue substitutes for the purposes of masculinizing genital gender affirming surgery. Additional background is provided for both topics to provide a more comprehensive understanding of the modern applications.
Imaging for upper tract urothelial carcinoma: update of the evidence and a glimpse into the future
Laukhtina E, Muin D and Shariat SF
Upper tract urothelial carcinoma (UTUC) is a rare malignancy posing significant diagnostic and management challenges. This review provides an overview of the evidence supporting various imaging modalities and offers insights into future innovations in UTUC imaging.
Upper tract urothelial carcinoma: epidemiology, presentation, and high-risk endemic populations
Clark CB, Matheny M and Raman JD
Upper tract urothelial carcinoma (UTUC) only accounts for 5-10% of all urothelial cancers but these patients present with high stage disease and 2 out of 3 patients have evidence of muscle-invasion at time of diagnosis. Furthermore, 10% of UTUC patients have associated Lynch syndrome and therefore diagnosis of UTUC should prompt timely evaluation and familial counseling. The purpose of this review is to outline the current evidence on the epidemiology, presentation, and high-risk endemic populations of UTUC through review of contemporary publications occurring over the preceding 18 months.
Upper tract urothelial carcinoma: conservative management - intraluminal adjuvant therapy, and surveillance
Lasmanovich R, Shvero A and Kleinmann N
In recent years, intraluminal therapies have become a valid alternative for low grade upper tract urothelial carcinoma (UTUC) patients, as overall survival and cancer-specific survival rates were shown to be comparable to those achieved with radical nephroureterectomy for selected cases. Nonetheless, endoscopic treatment has its limitations. As technology progresses and the demand for endoscopic treatments increases, intraluminal chemotherapy and immunotherapy instillations within the upper tract have increasingly become the subject areas of research.
Association and risk of metabolic syndrome and kidney stone disease: outcomes from a systematic review and meta-analysis
Dassanayake SN, Lafont T and Somani BK
Metabolic syndrome (MetS) has emerged as a potential contributor to the development of kidney stone disease (KSD). This study aims to conduct a systematic review of the literature, and meta-analysis of the association between MetS and KSD.
Perioperative platform for muscle-invasive bladder cancer trials: designs and endpoints
Laukhtina E, Moschini M, Teoh JY and Shariat SF
This review explores the design and endpoints of perioperative platforms in clinical trials for muscle-invasive bladder cancer (MIBC).
Adjuvant treatment for renal cell carcinoma: current status and future
Leung DKW, Siu BWH and Teoh JYC
Renal cell carcinoma (RCC) is resistant to chemotherapy. Adjuvant interferon and tyrosine kinase inhibitors were ineffective. Immune checkpoint inhibitors (ICIs), however, have shed new hope in this setting. In the current review, updated evidence of adjuvant therapy in RCC is summarized.
The role of radical cystectomy and lymphadenectomy in the management of bladder cancer with clinically positive lymph node involvement
Pfail J, Lichtbroun B, Golombos DM, Jang TL, Packiam VT and Ghodoussipour S
The role of radical cystectomy and pelvic lymph node dissection in muscle-invasive bladder cancer (MIBC) with clinically positive lymph nodes is debated. This review examines the role of surgery in treating patients with clinical N1 and more advanced nodal involvement (N2-N3) within a multimodal treatment approach.