Volume 15, Number 4Review ArticlesShort-, Intermediate-, and Long-term Quality of Life Outcomes Following Radical Prostatectomy for Clinically Localized Prostate CancerManagement ReviewTyler R McClintockVinay PrabhuTed LeeHerbert LeporMany clinically localized prostate cancers that are diagnosed today are low risk, and prevention of disease-specific mortality may only be realized decades after treatment. Radical prostatectomy (RP) may adversely impact health-related quality of life (HRQOL) by causing both transient or permanent urinary incontinence and erectile dysfunction. In contrast, RP may also improve HRQOL via relief of lower urinary tract symptoms in men suffering from these symptoms prior to surgery. Because the average man treated for prostate cancer has a life expectancy of approximately 14 years, it is imperative to consider the long-term impact of RP on both survival and HRQOL in treatment decision making. This comprehensive literature review examines short-, intermediate-, and long-term HRQOL following RP. In addition, the long-term results of RP are compared with other treatment modalities for treating clinically localized prostate cancer. [Rev Urol. 2013;15(4):161-177 doi: 10.3909/riu0604] © 2014 MedReviews®, LLCProstate cancerRadical prostatectomyHealth-related quality of life
Volume 16, Number 4Literature ReviewsHeterogeneity in Active Surveillance Protocols WorldwideProstate CancerR Scott BraithwaiteAngela FagerlinMark SchwartzBallentine CarterStacy LoebHerbert Lepor[Rev Urol. 2014;16(4):202-203 doi: 10.3909/riu0649] © 2014 MedReviews®, LLC
Volume 16, Number 2Review ArticlesFocal Laser Ablation for Localized Prostate Cancer: Principles, Clinical Trials, and Our Initial ExperienceTreatment UpdateDan SperlingNeil MendhirattaTed LeeHerbert LeporFocal therapy of prostate cancer is an evolving treatment strategy that destroys a predefined region of the prostate gland that harbors clinically significant disease. Although long-term oncologic control has yet to be demonstrated, focal therapy is associated with a marked decrease in treatment-related morbidity. Focal laser ablation is an emerging modality that has several advantages, most notably real-time magnetic resonance imaging (MRI) compatibility. This review presents the principles of laser ablation, the role of multiparametric MRI for delineating the site of significant prostate cancer, a summary of published clinical studies, and our initial experience with 23 patients, criteria for selecting candidates for focal prostate ablation, and speculation regarding future directions. [Rev Urol. 2014;16(2):55-66 doi: 10.3909/riu0615] © 2014 MedReviews® LLCProstate cancerFocal therapyTargeted therapyLaser ablation
Volume 17, Number 3Review ArticlesThe Role of Minimally Invasive Surgical Techniques in the Management of Large-gland Benign Prostatic HypertrophyManagement UpdateJames E LingemanMichael S BorofskyGanesh SivarajanOjas ShahHerbert LeporLower urinary tract symptoms (LUTS) secondary to benign prostatic hypertrophy (BPH) are among the most common medical issues for aging men. Population-based studies suggest that 13.8% of men in their 40s and more than 40% of men over age 60 have BPH. When LUTS are refractory to medical therapy and bothersome enough to warrant surgical intervention, transurethral resection of the prostate and open simple prostatectomy have been the historical reference-standard procedures for decades. Both procedures are highly effective and offer durable improvements in urinary functional outcomes. However, they also have the potential for considerable perioperative complications and morbidity. In an effort to limit surgical morbidity, a variety of minimally invasive surgical techniques to treat BPH have been introduced. Herein we present a comprehensive, evidence-based review of the efficacy and safety profile of modern minimally invasive treatments for large-gland BPH. [Rev Urol. 2015;17(3):140-149 doi: 10.3909/riu0675] © 2015 MedReviews®, LLCLower urinary tract symptomsRobotic simple prostatectomyBenign prostatic hypertrophyGreenLight photovaporizationHolmium laser enucleation of the prostate (HoLEP)
Volume 17, Number 1CommentaryUsing the 4Kscore Test and Magnetic Resonance Imaging Results to Avoid Unnecessary Prostate BiopsyHerbert Lepor[Rev Urol. 2015;17(1):1-2 doi: 10.3909/riu0668a] © 2015 MedReviews®, LLC
Volume 20, Number 2KOL InterviewManagement Options for NocturiaRoger R DmochowskiHerbert Lepor[Rev Urol. 2018;20(2):53–55 doi: 10.3909/riu0811] © 2018 MedReviews®, LLC
Volume 20, Number 2NYU Case of the MonthFocal Ablation of Prostate CancerNYU Case of the Month, June 2018Herbert Lepor[Rev Urol. 2018;20(2):107–111 doi: 10.3909/riu0812] © 2018 MedReviews, LLC®
Volume 20, Number 4Review ArticlesFocal Ablation of Prostate CancerTreatment UpdateSamuel GoldJames WysockHerbert LeporThe challenge to the urology community is to reduce the risks of screening and treatment by reducing the number of men undergoing unnecessary biopsy and whole-gland curative treatment of low-risk disease. There is compelling evidence that focal ablation of prostate cancer is truly minimally invasive and offers major functional advantages over whole-gland treatment. [Rev Urol. 2018;20(3):145–157 doi: 10.3909/riu0809] © 2019 MedReviews®, LLCProstate cancer screeningHigh-intensity focused ultrasoundIrreversible electroporationFocal ablationProstate cancer treatmentVascular targeted photodynamic therapy
Volume 21, Number 2Review ArticlesProstate Cancer Screening and Management in Solid Organ Transplant Candidates and RecipientsManagement ReviewAlex WangEzequiel BecherHerbert LeporThe number of solid organ transplantations is increasing worldwide. Major medical advances have allowed for incremented survival in this population, which, because approximately 50% of recipients are over age 50 years, makes for an increasingly older population of transplant survivors. This article discusses controversies and current guidelines related to prostate cancer (PCa) screening, detection, and treatment for men in the general population. The relevant literature is reviewed in order to provide insights on how to optimize PCa screening, detection, and treatment pre– and post–solid organ transplantation. There is compelling evidence that immunosuppression does not increase the risk for the development or progression of PCa following solid organ transplantation. Therefore, PCa screening, detection, or treatment should not be influenced by the impact of immunosuppression on the biology of the disease. Prostate-specific antigen (PSA) appears to be as reliable for PCa screening of transplant candidates and recipients as it is for the general population. There is no consensus on how or when it should be implemented. Evidence is also equivocal as to the suggested waiting time between treatment and transplantation. Surgery and radiation therapy appear to be safe and provide good outcomes for managing PCa in solid organ transplant candidates and recipients. However, certain precautions should be taken with this vulnerable population, especially for kidney transplant patients given the pelvic location of the renal graft. Partial gland ablation of PCa should be considered in appropriate candidates. [Rev Urol. 2019;21(2/3):85–92] © 2019 MedReviews®, LLC