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Treatment outcomeView Articles

Volume 18, Number 1Review Articles

Contemporary Role of the Decipher® Test in Prostate Cancer Management: Current Practice and Future Perspectives

Management Update

Deepansh DalelaBjörn LöppenbergAkshay SoodJesse SammonFiras Abdollah

We performed a systematic literature search to identify original articles and editorials about the Decipher® Prostate Cancer Test (GenomeDx Biosciences, San Diego, CA) to provide an overview of the current literature and its present role in urologic clinical practice. The Decipher test, which uses the expression of 22 selected RNA markers (from a total of over 1.4 million), showed a very high discrimination in predicting clinical metastasis (0.75-0.83) and cancer-specific mortality (0.78) in external validation studies, outperforming all routinely available clinicopathologic characteristics. Further, the timing of postoperative radiotherapy (adjuvant vs salvage) may be guided based on Decipher scores. The Decipher test was also the only independent predictor of clinical metastasis in patients with biochemical recurrence after surgery. The Decipher Genomic Resource Information Database (GRID) is a novel research tool that captures 1.4 million marker expressions per patient and may facilitate precision-guided, individualized care to patients with prostate cancer. In this era of precision medicine, Decipher, along with the Decipher GRID platform, is a promising genomic tool that may aid in managing prostate cancer patients throughout the continuum of care and delivering appropriate treatment at an individualized level. [Rev Urol. 2016;18(1):1-9 doi: 10.3909/riu0706] © 2016 MedReviews®, LLC

Prostate cancerDecipher® Prostate Cancer TestGenomic classifierNeoplasm recurrenceLocal/surgeryTreatment outcome

triomodal therapyView Articles
Trospium chlorideView Articles

Volume 7, Number 3Meeting Reviews

Best of the AUA 2005 Annual Meeting

Meeting Review

Ellen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K BrawerRandall B MeachamArie S BelldegrunJohn P SteinJohn T LeppertJohn S LamStephen J Freedland

Prostate cancerBenign prostatic hyperplasiaBladder cancerKidney cancerLower urinary tract symptomsBotulinum toxinVesicoureteral refluxProstate-specific antigenOveractive bladderPeyronie’s diseaseNomogramsPediatric urologyCryptorchidismVasectomy reversalChronic prostatitisBlockers5-reductase inhibitorsTrospium chlorideRenal stonesProstate volumeMedical Therapy ofProstatic Symptoms (MTOPS) studyMinimally invasive therapiesPremature ejaculationProstate Cancer Prevention TrialTyrol PSA Screening ProjectUrothelial cancer

TRUSView Articles
TuberculosisView Articles

Volume 17, Number 2Case Review

Genitourinary Presentation of Tuberculosis

Jerry Yuan

Tuberculosis (TB) is less common in developed countries; however, the incidence of TB—especially resistant strains—is on the rise worldwide. Cases of TB manifesting as urologic complications are rare in the United States. Urologists should be aware of this potential manifestation, especially in patients who have recently immigrated to the United States or have traveled abroad for prolonged periods. Two cases are presented here to illustrate this entity. [Rev Urol. 2015;17(2):102-105 doi: 10.3909/riu0679] © 2015 MedReviews®, LLC

TuberculosisGenitourinary complications

Tuberculosis, renalView Articles

Volume 10, Number 3Review Articles

Urogenital Tuberculosis: Update and Review of 8961 Cases from the World Literature

Treatment Update

André A FigueiredoAntonio M Lucon

The AIDS epidemic caused unexpected worldwide levels of tuberculosis, even in developed countries where the incidence used to be low. Patients with urogenital tuberculosis in developed countries have fewer specific symptoms and lower rates of delayed diagnoses compared with patients from other countries. As a result, the disease tends to be less serious, with more patients presenting without significant lesions of the upper urinary tract on diagnosis. These data point to a correlation of the timing of diagnosis with the severity of urogenital tuberculosis. A systematic search for urogenital tuberculosis, regardless of symptoms, is warranted for early detection. [Rev Urol. 2008;10(3):207-217]

CystitisNephrectomyMale genital tuberculosisTuberculosis, urogenitalTuberculosis, renalUrinary bladder, surgery

Tuberculosis, urogenitalView Articles

Volume 10, Number 3Review Articles

Urogenital Tuberculosis: Update and Review of 8961 Cases from the World Literature

Treatment Update

André A FigueiredoAntonio M Lucon

The AIDS epidemic caused unexpected worldwide levels of tuberculosis, even in developed countries where the incidence used to be low. Patients with urogenital tuberculosis in developed countries have fewer specific symptoms and lower rates of delayed diagnoses compared with patients from other countries. As a result, the disease tends to be less serious, with more patients presenting without significant lesions of the upper urinary tract on diagnosis. These data point to a correlation of the timing of diagnosis with the severity of urogenital tuberculosis. A systematic search for urogenital tuberculosis, regardless of symptoms, is warranted for early detection. [Rev Urol. 2008;10(3):207-217]

CystitisNephrectomyMale genital tuberculosisTuberculosis, urogenitalTuberculosis, renalUrinary bladder, surgery

Tuberous sclerosisView Articles

Volume 11, Number 4Case Review

Concurrent Bilateral Renal Angiomyolipoma and Renal Cell Carcinoma in a Patient With Tuberous Sclerosis Complex

Abdelhak KhalloukYounes AhallalMohamed Jamal El FassiMohamed Fadl TaziSoufiane MellasMbarek Doublali

Renal angiomyolipomas (AMLs) are often associated with tuberous sclerosis. These tumors are predominantly benign, although malignant forms do exist and are known to be associated with renal cell carcinoma. This case report describes a patient with tuberous sclerosis and massive bilateral AML. Total right nephrectomy was performed; histopathologic examination revealed the coexistence of AML and clear cell renal carcinoma in the same kidney. Because differentiation between renal cell carcinoma and AML with minimal or no fat component can be difficult, an accurate diagnosis is critical in the management of renal AML.[Rev Urol. 2009;11(4):216-218 doi: 10.3909/riu0436]© 2009 MedReviews®, LLC

Renal cell carcinomaAngiomyolipomaTuberous sclerosis

Tubulocystic renal cell carcinomaView Articles

Volume 18, Number 2Case Review

Tubulocystic Renal Cell Carcinoma: A Great Imitator

Tubulocystic renal cell carcinoma (TCRC) is a rare renal tumor. Patients are usually asymptomatic; it is usually detected incidentally, during imaging studies for Bosniak type III and type IV renal cysts. These tumors rarely metastasize. The role of targeted therapy in such rare tumors is still controversial. We report a case of TCRC initially presented as a Bosniak type II renal cyst and was discovered ultimately to be a metastatic disease. This type of presentation might broaden our understanding of this rare disease. [Rev Urol. 2016;18(2):118-121 doi: 10.3909/riu0692] © 2016 MedReviews®, LLC

Tubulocystic renal cell carcinomaBosniak type II cystTargeted therapy

TumorView Articles
Tumor gradeView Articles

Volume 16, Number 1Review Articles

Nephron-sparing Management of Upper Tract Urothelial Carcinoma

Management Review

Tommaso BrancatoFrancesca Suriano

Upper tract urothelial carcinoma (UTUC) is a relatively rare tumor, but is characterized by high rates of recurrence, morbidity, and mortality. Choice of treatment modality is generally influenced by lesion size, grade, and focality. Radical nephroureterectomy with bladder cuff excision is the gold-standard management of UTUC, although an organ-sparing approach may be beneficial in selected patients. Conservative endoscopic management of UTUC in appropriate patients has a favorable impact on quality of life and health care costs when compared with patients who progress to dialysis-dependent renal failure. Careful ureteroscopic surveillance following endoscopic management of UTUC is essential. [Rev Urol. 2014;16(1):21-28 doi: 10.3909/riu0592] © 2014 MedReviews®, LLC

Upper tract urothelial carcinomaTumor gradeNephron-sparing endoscopic treatmentTopical adjuvant chemo-immunotherapyOncologic outcomes

Tumor marker testsView Articles
Tumor markersView Articles
Tumor vaccinesView Articles

Volume 9, Supplement 1Review Articles

Immunotherapy for Advanced Prostate Cancer

New Directions in the Management of Advanced Prostate Cancer

Johannes Vieweg

The absence of curative therapies for advanced or recurrent forms of prostate cancer mandates continued development of novel, more effective treatment regimens. Due to recent advances in basic and translational research, therapeutic vaccines and monoclonal antibody-based therapies are steadily gaining ground as promising treatment modalities against prostate cancer. Several immunotherapeutic products have recently been investigated in later-phase trials and have reported evidence for clinical benefit while maintaining an excellent quality of life for participants. The cumulative clinical results available to date indicate that immune-based therapies will likely play a role in the treatment of patients with prostate and other malignancies. The objective of this article is to increase awareness of contemporary immunologic therapies and clinical trials of new biologic reagents against prostate cancer. We also seek to encourage urologists to actively participate in clinical trials and evaluate the potential of immunotherapeutic drugs for impacting standards of care. [Rev Urol. 2007;9(suppl 1):S29-S38]

Prostate cancerImmunotherapyTumor vaccinesMonoclonal antibodies

Tumor-node-metastasis classificationView 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

TumorsView Articles

Volume 13, Number 1Review Articles

α-Fetoprotein-Producing Non-Germ Cell Tumors of the Urological System

Diagnostic Review

Mona El-Bahrawy

"Elevated serum levels of _ -fetoprotein (AFP), a fetal serum protein, occur mainly in the development of hepatocellular carcinoma (HCC) or germ cell tumors, mainly yolk sac tumor. Rarely, other tumors of the urological system produce AFP. This article reviews the AFP-producing non-germ cell tumors of the urological tract reported to date. These include different types of tumors of the adrenal glands, kidney, ureter, urinary bladder, and testis. It is important for pathologists, urologists, and oncologists to be aware of such cases as the diagnosis affects the management plan for the patient. [Rev Urol. 2011;13(1):14-19 doi: 10.3909/riu0506]"

FetoproteinGerm cellTumorsUrological system

TURPView Articles

Volume 8, Number 4Meeting Reviews

Advances in the Treatment of Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia

Meeting Review

Claus G Roehrborn

Highlights from the 21st European Association of Urology Congress, April 5–8, 2006, Paris, France [Rev Urol. 2006;8(4):216-225]

Benign prostatic hyperplasiaNocturiaLower urinary tract symptomsAlfuzosinProstatectomyPDE-5 inhibitorsTURPDutasterideSexual dysfunctionAcute urinary retentionChronic inflammatory infiltratesPVPHigh-energy transurethral microwave thermotherapy

Tyrol PSA Screening ProjectView Articles

Volume 7, Number 3Meeting Reviews

Best of the AUA 2005 Annual Meeting

Meeting Review

Ellen ShapiroAlan W PartinMichael B ChancellorJ Curtis NickelJacob RajferClaus G RoehrbornMichael K BrawerRandall B MeachamArie S BelldegrunJohn P SteinJohn T LeppertJohn S LamStephen J Freedland

Prostate cancerBenign prostatic hyperplasiaBladder cancerKidney cancerLower urinary tract symptomsBotulinum toxinVesicoureteral refluxProstate-specific antigenOveractive bladderPeyronie’s diseaseNomogramsPediatric urologyCryptorchidismVasectomy reversalChronic prostatitisBlockers5-reductase inhibitorsTrospium chlorideRenal stonesProstate volumeMedical Therapy ofProstatic Symptoms (MTOPS) studyMinimally invasive therapiesPremature ejaculationProstate Cancer Prevention TrialTyrol PSA Screening ProjectUrothelial cancer

Tyrosine kinase inhibitorsView Articles

Volume 14, Number 3Review Articles

Systemic Therapy for Metastatic Renal Cell Carcinoma: A Review and Update

Management Update

Karim ChamieJoshua E LoganEdward N RampersaudGeoffrey A SonnDennis J SlamonFairooz F KabbinavarArie S BelldegrunAllan J Pantuck

An in-depth understanding of metastatic renal cell carcinoma (mRCC) is important so that practitioners can make informed evidenced-based decisions with patients to optimize not only quantity of life but quality of life as well. Therefore, this review focuses on the biology of mRCC as it relates to targets for therapy, as well as on the small molecules rationally designed with these targets in mind. In addition, anticipated emerging therapies are highlighted, including the new tyrosine kinase inhibitors axitinib and tivozanib, as well as new immune-based therapies such as dendritic cell-based vaccines and antibodies. We also briefly review recent reports from the emerging field of predicting drug response based on molecular markers. And finally, management of metastatic non-clear cell RCC histologies are discussed focusing on available evidence to direct decision making when assessing therapeutic options. [Rev Urol. 2012;14(3/4):65-78 doi: 10.3909/riu0562] © 2013 MedReviews®, LLC

Metastatic renal cell carcinomaTyrosine kinase inhibitorsDendritic cell-based vaccines

UltrasonographyView Articles
Ultrasonography, DopplerView Articles
UltrasoundView Articles
Ultrasound-estimated bladder weightView Articles

Volume 10, Number 2Meeting Reviews

Best of the 2008 AUA Annual Meeting

Meeting Review

Dean G AssimosDanil V MakarovAlan W PartinMichael B ChancellorJ Curtis NickelClaus G RoehrbornMichael K BrawerNaoki YoshimuraShing-Hwa Lu

Highlights from the 2008 Annual Meeting of the American Urological Association, May 17-22, 2008, Orlando, FL [Rev Urol. 2008;10(2):136-156]

Focal therapyProstate-specific antigenShock wave lithotripsyTumor markersOveractive bladder syndromeBlockersEarly prostate cancer antigenTMPRSS2-ERGCryotherapyUltrasound-estimated bladder weightElocalcitolLithium triboride laserStone formation

Ultrasound, high-inten sity focused, transrectalView Articles

Volume 11, Number 4Review Articles

Focal Therapy: A New Paradigm for the Treatment of Prostate Cancer

Treatment Update

Samir S TanejaBasir TareenGuilherme Godoy

Focal therapy has been proposed in recent years as a means of bridging the gap between radical prostatectomy and active surveillance for treatment of prostate cancer. The rationale for focal therapy comes from its success in treating other malignancies. One of the challenges in applying such an approach to the treatment of prostate cancer has been the multifocal nature of the disease. This review addresses the selection of potentially ideal candidates for focal therapy and discusses which modalities are currently being used and proposed for focal therapy. Setting and meeting guidelines for oncologic efficacy is a challenge we must embrace to safely deliver this potentially revolutionary approach to treating men with prostate cancer.[Rev Urol. 2009;11(4):203-212 doi: 10.3909/riu0475]© 2009 MedReviews®, LLC

Prostatic neoplasmsFocal therapyProstate-specific antigenProstatectomyPhotodynamic therapyUltrasound, high-inten sity focused, transrectalCryosurgery

Ultrasoundestimated bladder weightView Articles
Ultrasoundestimatedbladder weightView Articles
Underactive bladderView Articles

Volume 15, Number 1Review Articles

The Other Bladder Syndrome: Underactive Bladder

Management Review

Michael B ChancellorMinoru MiyazatoNaoki Yoshimura

Detrusor underactivity, or underactive bladder (UAB), is defined as a contraction of reduced strength and/or duration resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. UAB can be observed in many neurologic conditions and myogenic failure. Diabetic cystopathy is the most important and inevitable disease developing from UAB, and can occur silently and early in the disease course. Careful neurologic and urodynamic examinations are necessary for the diagnosis of UAB. Proper management is focused on prevention of upper tract damage, avoidance of overdistension, and reduction of residual urine. Scheduled voiding, double voiding, al-blockers, and intermittent self-catheterization are the typical conservative treatment options. Sacral nerve stimulation may be an effective treatment option for UAB. New concepts such as stem cell therapy and neurotrophic gene therapy are being explored. Other new agents for UAB that act on prostaglandin E2 and EP2 receptors are currently under development. The pharmaceutical and biotechnology industries that have a pipeline in urology and women’s health may want to consider UAB as a potential target condition. Scientific counsel and review of the current pharmaceutical portfolio may uncover agents, including those in other therapeutic fields, that may benefit the management of UAB. [Rev Urol. 2013;15(1):11-22 doi: 10.3909/riu0558] © 2013 MedReviews®, LLC

Underactive bladderOveractive bladderDetrusor overactivityDiabetic cystopathy

Undescended testisView Articles
Unilateral renal agenesisView Articles
United StatesView Articles

Volume 17, Number 3Review Articles

Impact of the US Preventive Services Task Force Grade D Recommendation: Assessment of Evaluations for Elevated Prostate-specific Antigen and Prostate Biopsies in a Large Urology Group Practice Followi

Treatment Impact Assessment

Gregory C McMahonGordon A BrownKathleen F McGinley

On October 7, 2011, the United States Preventive Services Task Force (USPSTF) released their evidence statement and grade D recommendation against prostate-specific antigen (PSA)–based prostate cancer screening. Using a time series design, we assessed the effect of this recommendation upon evaluations for elevated PSA levels and prostate biopsies in our large urology group practice. We found that, despite a 24.1% increase in total visits, the 32 urologists in our practice completed 16.4% fewer evaluations for elevated PSA levels (317 fewer evaluations per month; P = .017) and 21.4% fewer prostate biopsies (42 fewer biopsies per month; P = .001) in the 2 years following the USPSTF grade D recommendation. [Rev Urol. 2015;17(3):171-177 doi: 10.3909/riu0696] © 2015 MedReviews®, LLC

Prostate cancer screeningProstate-specific antigenProstate biopsiesUnited States