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Este mes en... Nature Reviews Urology

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Este mes en... Nature Reviews Urology:

  • Variation in clinical practice: forests and trees revisited
    Variations in clinical practice are commonly viewed as a sign of uneven quality of care and attributed to provider self-interest. However, patient preferences, physician practice patterns, and diagnostic and therapeutic uncertainty also cause variations. Greater attention to both doctor–patient interactions and limits to the available
  • Bladder cancer: oligometastases and imaging
    The term oligometastases was introduced to describe patients with limited metastatic disease in whom treatment might result in long-term disease-free survival or even cure. Imaging is pivotal for identification of these patients. The definition of oligometastatic bladder cancer and the optimal imaging modalities for diagnosis
  • Bladder cancer: PPARγ-RXRα alterations promote immune evasion
    The introduction and subsequent FDA approval of antibodies that inhibit immune checkpoints or their endogenous ligand, such as the anti-PD1-antibodies nivolumab and pembrolizumab, or the anti-PD-L1 antibodies atezolizumab, avelumab and durvalumab, has dramatically improved the outcomes of a subset of patients with metastatic urothelial carcinoma.
  • Urothelial carcinoma: Genomic characterization of UTUC
    Genomic analyses of 31 untreated upper tract urothelial carcinoma (UTUC) samples using DNA whole-exome sequencing, RNA sequencing, and reverse-phase protein array identified four unique subtypes that have mutational frequencies that differ from bladder cancer. The most common DNA mutations were in FGFR3, KMT2D,
  • Sexual dysfunction: Shortened CCH treatment for Peyronie's disease
    A new modified protocol of collagenase clostridium histolyticum (CCH) treatment for Peyronie's disease comprising only three instead of eight CCH injections was found to be safe and effective in a single-centre setting. In a cohort of men with mean penile curvature of 54° at baseline,
  • Urinary incontinence: Evaluating bladder wall properties with vibrometry
    Ultrasound bladder vibrometry (UBV) might be a noninvasive technique to monitor changes in bladder wall mechanical properties in patients with neurogenic bladder dysfunction. Concurrent UBV and urodynamic assessment at different filling volumes were performed in 56 men and 14 women. Group velocity squared and elasticity
  • Urinary incontinence: Stem cell therapy for chronic bladder ischaemia
    In a rat model of atherosclerosis-induced chronic bladder ischaemia, bladder overactivity could be improved by human amniotic-fluid-derived stem cell (hAFSC) treatment. Following arterial balloon endothelial injury of the common iliac artery, adult female rats received intravenous hAFSC treatment for 1, 3, or 7 days, or
  • Prostate cancer: The pathway to progression: DHT biosynthesis
    New data, published in Clinical Cancer Research, provide evidence that the transition of primary prostate cancer to castration-resistant disease could coincide with a switch in the preferred metabolic pathway of dihydrotestosterone (DHT) biosynthesis in tumour tissue. This observation increases our understanding of progression to
  • Infection: Proceed with CAUTIon
    Two recent papers in the American Journal of Infection Control have focussed on the changing epidemiology of catheter-associated urinary tract infection (CAUTI).The first investigated whether the rates of CAUTI have changed since 2011, when public reporting was implemented. Metersky et al.
  • Incontinence: Patients prefer combination therapy
    Combination therapy with muscarinic receptor antagonists (such as solifenacin) and mirabegron, a β3-adrenoceptor agonist, has synergistic effects that enable the long-term management of overactive bladder (OAB) symptoms; however, the balance between efficacy and tolerability of this combination versus that of monotherapy with either
  • Kidney cancer: Savolitinib — a saviour for papillary RCC?
    Savolitinib, a selective inhibitor of the MET tyrosine kinase pathway, demonstrates activity and tolerability in patients with papillary renal cell cancer (pRCC), according to data published in the Journal of Clinical Oncology.Although clear cell RCC is the most common histological subtype of renal
  • Immunology: PD-1 and PD-L1 prognostic in UTUC
    Expression of programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1) has prognostic value in patients with high-grade upper tract urothelial carcinoma (UTUC), according to new data published in The Journal of Urology.Samples from 423 patients receiving extirpative surgery for
  • Prostate cancer: Mutations in ctDNA reflect features of metastatic disease
    Regular biopsy sampling enables the personalized management of patients with metastatic castration-resistant prostate cancer (mCRPC); however, such sampling is invasive, carries the risk of complications, and might fail to capture all of the specific characteristics of a patient's disease. Now, a systematic comparison of matched
  • Infection: The urinary microbiota is unique and resilient
    Patients with lower urinary tract symptoms (LUTS) owing to spinal cord injury or neurodegenerative disease often manage their long-term symptoms using catheterization. Although largely effective, this approach carries a major risk of recurrent UTI owing to colonization of the catheter. Now, data from three patients
  • Prostate cancer: Subtype linked to germline variant
    A new study published in Nature Communications shows that a germline single-nucleotide polymorphism (SNP) in chromosome 7 could predispose men to a prostate cancer subtype characterized by early somatic mutation in SPOP and dysregulated transcription of DNA repair and androgen receptor (AR)-responsive genes.
  • Prostate cancer: Microbiome — the 'unforeseen organ'
    The advent of molecular methods for the identification and characterization of the microbiome has led researchers to understand the role of the microbiota in various clinical conditions. Research by Cavarretta and colleagues has revealed the presence of microbial dysbiosis and its potential relationship with pathophysiology in the prostate tumour microenvironment. This finding could potentially enable future investigations that clarify the role of the microbiota in the development of prostate cancer and its future management, from a different perspective.
  • Varicocele and male infertility
    The link between varicoceles and male infertility has been a matter of debate for more than half a century. Varicocele is considered the most common correctable cause of male infertility, but some men with varicoceles are able to father children, even without intervention. In addition,
  • Risk factors for cryptorchidism
    Undescended testis — known as cryptorchidism — is one of the most common congenital abnormalities observed in boys, and is one of the few known risk factors for testicular cancer. The key factors that contribute to the occurrence of cryptorchidism remain elusive. Testicular descent is
  • Radiotherapy for renal cell carcinoma: renaissance of an overlooked approach
    Conventional radiotherapy previously had a limited role in the definitive treatment of renal cell carcinoma (RCC), owing to the disappointing outcomes of several trials and the perceived radioresistance of this type of cancer. In this context, radiotherapy has been relegated largely to the palliation of
  • Landmarks in the treatment of muscle-invasive bladder cancer
    Muscle-invasive bladder cancer is an aggressive disease associated with high morbidity and mortality. Radical cystectomy is the mainstay of treatment and has evolved since the first reported cystectomy in 1887 to include pelvic lymph node dissection and the creation of increasingly sophisticated urinary diversions, such
  • Cardiovascular toxicities of systemic treatments of prostate cancer: oestrogen to the rescue?
    In their Review (Cardiovascular toxicities of systemic treatments of prostate cancer. Nat. Rev. Urol. 14, 230–243 (2017)) Veccia et al. offer useful insight into current knowledge concerning cardiovascular complications of oral oestrogen, androgen deprivation therapy (ADT), and prostate cancer.
  • Cardiovascular toxicities of systemic treatments of prostate cancer: is oestrogen to the rescue?
    We thank Shah and colleagues for their interest in our article (Cardiovascular toxicities of systemic treatments of prostate cancer. Nat. Rev. Urol. 14, 230–243 (2017)), which raised some important points regarding the administration route for oestrogen therapy for prostate cancer (Cardiovascular


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