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Mitomycin CView Articles

Volume 15, Number 4Review Articles

Intracavitary Immunotherapy and Chemotherapy for Upper Urinary Tract Cancer: Current Evidence

Systematic Review

Luca CarmignaniRoberto BianchiGabriele CozziNicola MacchioneCarlo MarenghiSara MelegariMarco RossoElena TondelliAugusto MaggioniAngelica Grasso

A review of the literature was performed to summarize current evidence regarding the efficacy of topical immunotherapy and chemotherapy for upper urinary tract urothelial cell carcinoma (UUT-UCC) in terms of post-treatment recurrence rates. A Medline database literature search was performed in March 2012 using the terms upper urinary tract, urothelial cancer, bacillus Calmette-Guérin (BCG), and mitomycin C. A total of 22 full-text articles were assessed for eligibility, and 19 studies reporting the outcomes of patients who underwent immunotherapy or chemotherapy with curative or adjuvant intent for UUT-UCC were chosen for quantitative analysis. Overall, the role of immunotherapy and chemotherapy for UUT-UCC is not firmly established. The most established practice is the treatment of carcinoma in situ (CIS) with BCG, even if a significant advantage has not yet been proven. The use of BCG as adjuvant therapy after complete resection of papillary UUT-UCC has been studied less extensively, even if recurrence rates are not significantly different than after the treatment of CIS. Only a few reports describe the use of mitomycin C, making it difficult to obtain significant evidence. [Rev Urol. 2013;15(4):145-153 doi: 10.3909/riu0579] © 2014 MedReviews®, LLC

ImmunotherapyChemotherapyBacillus Calmette-GuérinUpper urinary tractUrothelial cell carcinomaMitomycin C

MitoxantroneView Articles
Mixed incontinenceView Articles
Mixed urinary incontinenceView Articles

Volume 17, Number 2Review Articles

Diagnosis, Evaluation, and Treatment of Mixed Urinary Incontinence in Women

Diagnosis and Treatment Update

Steven A KaplanLeanna LaorClaire DunphyRichard LeeBilal ChughtaiAlexis E Te

Mixed urinary incontinence (MUI) is a common clinical problem in the community and hospital setting. The broad definition of the term makes it difficult to diagnose, as well as determine effective treatment strategies. There are no current guidelines recommended for physicians. The estimated prevalence of this condition is approximately 30% in all women with incontinence. It has also been suggested that patients with MUI report more bothersome symptoms than either stress or urge incontinence; approximately 32% of 40- to 64-year-olds with MUI report symptoms of depression. The authors examine the diagnosis, evaluation, and treatment of patients with MUI. [Rev Urol. 2015;17(2):78-83 doi: 10.3909/riu0653] © 2015 MedReviews®, LLC

Mixed urinary incontinenceDetrusor overactivityStress incontinenceUrge incontinenceUrodynamic stress incontinencePelvic organ prolapseTransvaginal tape

Modifier 25View Articles
MolecularView Articles
Molecular diagnosticsView Articles

Volume 10, Number 1Review Articles

Clinical Utility of Prostate Carcinoma Molecular Diagnostic Tests

Diagnostic Update

Scott B Shappell

Instead of relying on serum prostate-specific antigen (PSA) to identify patients for prostate biopsy, new laboratory tests are needed that have improved specificity for prostate carcinoma (CaP), allow accurate classification of clinically insignificant CaPs, allow for detection of clinically significant CaP in patients without elevated serum PSA, and allow for identification of aggressive forms of CaP, which may warrant adjunctive or even molecularly targeted therapy in the future. Over the last several years, highthroughput gene expression profiling and proteinomics have led to the identification of genes and proteins that are specifically overexpressed in CaP. Molecular diagnostic techniques readily translated to the clinical laboratory have been incorporated into the development of new tests based on these novel molecular alterations in CaP. Some of these tests already have well-documented clinical utility, such as in facilitating prostate biopsy decisions, and are routinely available. The current review focuses on the biological, clinical, and laboratory aspects of the most promising of these current and nearfuture molecular CaP tests. [Rev Urol. 2008;10(1):44-69]

Molecular diagnosticsProstate carcinomaProstate cancer antigen 3Alpha-methylacyl-CoA racemaseEarly prostate cancer antigenTransmembrane protease,serine 2ERGDNARNA

molecular imagingView Articles

Volume 23, Number 4Kidney Cancer

Imaging Techniques in the Diagnosis of Renal Cell Carcinoma: Contemporary Trends and Future Directions

Gautam Jayram

Increasing radiographic detection of incidental small renal masses has led to a growing concern regarding overtreatment of these lesions. Given the limitations of computed tomography and magnetic resonance imaging, there is an unmet need for improved kidney imaging techniques that can provide more accurate assessments of renal lesions. This review provides a summary of established kidney imaging modalities and also those likely to be meaningful in the near future. Kidney imaging has evolved, with several modalities contributing to the overall diagnostic landscape. There is great optimism that a new era of molecular imaging in renal cell carcinoma can vastly improve diagnostic capabilities and limit unnecessary invasive procedures.

Carcinoma, renal cellCarcinomaKidney neoplasmsmolecular imagingpositron-emission tomography

Molecular markersView Articles

Volume 9, Number 2Review Articles

Understanding the Natural Biology of Kidney Cancer: Implications for Targeted Cancer Therapy

Treatment Update

Arie S BelldegrunAllan J PantuckTobias KlatteMark D Kleid

During the past several decades, there has been a significant increase in the understanding of the biology, clinical behavior, and prognostic factors of renal cell carcinoma (RCC). Such progress has led to greater sophistication in the diagnosis and classification of RCC. Here, we review recent advances in our knowledge of the biologic characteristics of RCC that have resulted in notable achievements in staging, prognosis, patient selection, and treatment. [Rev Urol. 2007;9(2):47-56]

AngiogenesisGeneticsMolecular markersTargeted treatmentTumor-node-metastasis classification

Molecular mechanismsView Articles

Volume 10, Number 1Review Articles

Superficial Bladder Cancer: An Update on Etiology, Molecular Development, Classification, and Natural History

Treatment Update

Richard J CoteDavid Y JosephsonAnirban P MitraErik PasinJohn P Stein

Superficial “non–muscle-invasive” bladder tumors represent a heterogeneous group of cancers, including those that are (1) papillary in nature and limited to the mucosa, (2) high grade and flat and confined to the epithelium, and (3) invasive into the submucosa, or lamina propria. The goal of treatment is 2-fold: (1) to reduce tumor recurrence and the subsequent need for additional therapies and the morbidity associated with these treatments and (2) to prevent tumor progression and the subsequent need for more aggressive therapy. This update reviews important contemporary concepts in the etiology, molecular mechanisms, classification, and natural history of superficial bladder cancer. [Rev Urol. 2008;10(1):31-43]

Transitional cell carcinomaBladder neoplasmsNon–muscle-invasive tumorMolecular mechanismsGenitourinary tumors

Monoclonal antibodiesView Articles

Volume 23, Number 3Bladder Cancer

Immune Checkpoint Inhibitors for the Treatment of Non–Muscle-Invasive Bladder Cancer: An Overview of Ongoing Clinical Trials

Neal D Shore

Treatment of non–muscle-invasive bladder cancer (NMIBC) is evolving, seeking new treatments to overcome the limitations of bacille Calmette-Guérin therapy and alternatives to radical cystectomy. Studies are currently evaluating the safety and efficacy of immune checkpoint inhibitors in combination with bacille Calmette-Guérin vs bacille Calmette-Guérin monotherapy for patients with high-risk NMIBC that is bacille Calmette-Guérin naive or recurrent after bacille Calmette-Guérin induction. We briefly summarize 4 studies that are evaluating intravenous immune checkpoint inhibitors (atezolizumab, durvalumab, and pembrolizumab) and 1 subcutaneous immune checkpoint inhibitor (sasanlimab). These studies may substantially change standard-of-care treatment for patients with high-risk NMIBC.

immune checkpoint inhibitorsMonoclonal antibodiesClinical trialsnon-muscle invasive bladder neoplasms

Monoclonal antibodyView Articles
MonotherapyView Articles

Volume 13, Number 1Review Articles

Medical Treatment of Benign Prostatic Hyperplasia

Disease State Review

Herbert Lepor

"Medical therapy for the treatment of benign prostatic hyperplasia (BPH) became an accepted standard of care in the 1990s following the reports of randomized, double-blind, placebo-controlled studies showing that finasteride, a 5-_ reductase inhibitor, and terazosin, an _-blocker, significantly improved lower urinary tract symptoms and increased peak urinary flow rates in men with BPH. This article reviews novel approaches to the pharmacological treatment of BPH. [Rev Urol. 2011;13(1):20-33 doi: 10.3909/riu0519]"

Benign prostatic hyperplasiaLower urinary tract symptomsMonotherapy

Monti ileovesicostomyView Articles
MoodView Articles
Morbid obesityView Articles

Volume 17, Number 3Review Articles

The Obesity Epidemic and Its Impact on Urologic Care

Management Update

Neil BaumDavid Mobley

Although heart disease and cancer are the number one and two causes of death in the United States, respectively, obesity is gaining speed as a contributing cause to both of those conditions, along with diabetes, arthritis, dyslipidemia, coronary heart disease, gallbladder disease, and certain malignancies. Nearly one-third of the adults in the United States is overweight with a body mass index (BMI) greater than 25 kg/m2, and another third of the adult population is obese, with a BMI greater than 30 kg/m2. This article reviews the root causes of obesity, the societal implications, and the implications of obesity on various urologic diseases. [Rev Urol. 2015;17(3):165-170 doi: 10.3909/riu0683] © 2015 MedReviews®, LLC

ObesityMorbid obesityBody mass indexExerciseWeight lossDietEpidemic

MorbidityView Articles
MorcellationView Articles
Mortality ratesView Articles
Mortality riskView Articles

Volume 9, Supplement 2Review Articles

High-Risk, Clinically Localized Prostate Cancer: Is Monotherapy Adequate?

Androgen-Independent Prostate Cancer

Mark H KatzJames M McKiernan

High-risk, clinically localized prostate cancer represents a diverse disease entity. Patients who are considered to be at highest risk for biochemical failure after localized treatments may not be at significant risk for diseasespecific mortality. In this review, an attempt will be made to define high-risk status and help identify patients at high risk for mortality after a diagnosis of localized prostate cancer. Subsequently, a review of monotherapy approaches as well as previously successful strategies utilizing multimodality therapy for high-risk disease will be presented. Finally, a synopsis will be given of several ongoing randomized clinical trials using the most effective systemic therapies in the adjuvant setting following thorough local treatments such as radical prostatectomy. This review will provide a glimpse into the future and describe the tools that it is hoped will improve further upon the results of surgical monotherapy for high-risk, localized prostate cancer. [Rev Urol. 2007;9(suppl 2):S19-S27]

Prostate cancerRadical prostatectomyHigh-risk, localized prostate cancerMortality riskMultimodality therapy

mpMRIView Articles
MRIView Articles
MRI compatibleView Articles

Volume 11, Number 1Review Articles

Robotic Image-Guided Needle Interventions of the Prostate

Technology Update

Alan W PartinPierre C MozerDan Stoianovici

Prostate biopsy and needle-directed prostate therapies are currently performed free-handed or with needle external templates under ultrasound guidance. Direct image-guided intervention robots are modern instruments that have the potential to substantially enhance these procedures. These may increase the accuracy and repeatability with which needles are placed in the gland. The authors’ group has developed a robot for precise prostate targeting that operates remotely alongside the patient in the magnetic resonance imaging scanner, as guided according to the image.[Rev Urol. 2009;11(1):7-15]

ProstateRobotDirect image-guided intervention (DIGI)MRI compatible

MRI-guided biopsyView Articles

Volume 17, Number 3Meeting Reviews

Highlights From the 2015 American Urological Association Annual Meeting, May 15-19, 2015, New Orleans, LA

Best of the 2015 AUA Annual Meeting

Dean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorStacy LoebJ Curtis NickelMichael A GorinMichael K BrawerHeinz NicolaiÁine Goggins

[Rev Urol. 2015;17(3):179-189 doi:10.3909/riu0681] © 2015 MedReviews®, LLC

Active surveillanceHypospadias4KscoreProlarisStress urinary incontinencePatient phenotypingChronic pelvic pain syndromeEXO106 testMRI/US fusion biopsyOxalobacter formigenesUreteroscopic stone removalDecipher assayRadiation cystitisOccult tethered cord syndromeMRI-guided biopsy

MRI/US fusion biopsyView Articles

Volume 17, Number 3Meeting Reviews

Highlights From the 2015 American Urological Association Annual Meeting, May 15-19, 2015, New Orleans, LA

Best of the 2015 AUA Annual Meeting

Dean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorStacy LoebJ Curtis NickelMichael A GorinMichael K BrawerHeinz NicolaiÁine Goggins

[Rev Urol. 2015;17(3):179-189 doi:10.3909/riu0681] © 2015 MedReviews®, LLC

Active surveillanceHypospadias4KscoreProlarisStress urinary incontinencePatient phenotypingChronic pelvic pain syndromeEXO106 testMRI/US fusion biopsyOxalobacter formigenesUreteroscopic stone removalDecipher assayRadiation cystitisOccult tethered cord syndromeMRI-guided biopsy

MRSIView Articles
MSPView Articles

Volume 9, Number 3Meeting Reviews

Best of the 2007 AUA Annual Meeting

Meeting Review

Dean G AssimosDanil V MakarovEllen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K Brawer

Highlights from the 2007 Annual Meeting of the American Urological Association May 19-24, 2007 Anaheim, CA [Rev Urol. 2007;9(3):133-154]

Prostate cancerObesityBenign prostatic hyperplasiaAntibiotic prophylaxisNocturiaLower urinary tract symptomsBotulinum toxinProstate-specific antigenBiomarkersPCA3TestosteroneUrinary tract infectionsUrolithiasisLaser ablationEndourologyMale voiding dysfunctionLHRH antagonistsAntimuscarinic agentsCircumcisionRepeat biopsyHuman glandularkallikreinExpectant managementCRISP-3MSPMicrovesseldensityEndoglinSurvivinTelomeresInterleukin-8PDE-5 inhibitorsAcute urinaryretention5Alpha-reductase inhibitorsDoxazosinFinasterideTransurethral microwave thermotherapyTURPPerioperative blood lossMicrobialbiofilmsHIVStem cell injection

MTOPS trialView Articles

Volume 5, Number 3Meeting Reviews

Best of the 2003 AUA Annual Meeting

Highlights from the 2003 Annual Meeting of the American Urological Association, April 26-May 1, 2003

Dean G AssimosEllen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K BrawerRandall B MeachamBob DjavanArie S BelldegrunAllan J PantuckMesut RemziMichael DobrovitsMatthew B GretzerKazumasa Torimoto

Prostate cancerRenal cell carcinomaBenign prostatic hyperplasiaDepressionBladder cancerLower urinary tract symptomsUrinary tract infectionProstate-specific antigenNephrolithiasisOveractive bladderRadical prostatectomyPeyronie’s diseaseGleason scoreTransrectal ultrasoundErectile dysfunctionChronic prostatitis/chronic pelvic pain syndromeAcute urinary retentionInternational Prostate Symptom ScoreBacille Calmette-Guérin therapyChronic Prostatitis Symptom IndexMTOPS trialPLESS studyProstate tumor markersSELDI-TOF

MultidisciplinaryView Articles
Multimodal therapyView Articles

Volume 14, Number 1Review Articles

LHRH Agonists for the Treatment of Prostate Cancer: 2012

Management Review

Neal D ShoreHerbert Lepor

The most recent guidelines on prostate cancer screening from the American Urological Association (2009), the National Comprehensive Cancer Network (2011), and the European Association of Urology (2011), as well as treatment and advances in disease monitoring, have increased the androgen deprivation therapy (ADT) population and the duration of ADT usage as the first-line treatment for metastatic prostate cancer. According to the European Association of Urology, gonadotropin-releasing hormone (GnRH) agonists have become the leading therapeutic option for ADT because they avoid the physical and psychological discomforts associated with orchiectomy. However, GnRH agonists display several shortcomings, including testosterone (T) surge (“clinical flare”) and microsurges. T surge delays the intended serologic endpoint of T suppression and may exacerbate clinical symptoms. Furthermore, ADT manifests an adverse-event spectrum that can impact quality of life with its attendant well-documented morbidities. Strategies to improve ADT tolerability include a holistic management approach, improved diet and exercise, and more specific monitoring to detect and prevent T depletion toxicities. Intermittent ADT, which allows hormonal recovery between treatment periods, has become increasingly utilized as a methodology for improving quality of life while not diminishing chronic ADT efficacy, and may also provide healthcare cost savings. This review assesses the present and potential future role of GnRH agonists in prostate cancer and explores strategies to minimize the adverse-event profile for patients receiving ADT. [ Rev Urol. 2012;14(1/2):1-12 doi:10.3909/riu0547 ] © 2012 MedReviews®, LLC

Wilms’ tumorRenal massOpen radical nephrectomyMultimodal therapy