Articles in 2015

HIV and bacterial sexually transmitted infection incidence remains persistently high for men who have sex with men. Results of new studies show that clinicians might be able to address this challenge by providing oral HIV pre-exposure prophylaxis and by intensifying efforts to diagnose and treat other sexually transmitted infections.

Kisspeptin, peptide hormone that signals via the G protein-coupled kisspeptin receptor (KISS1R), has been implicated in various physiological and pathophysiological processes in the urogenital system, including roles in oocyte development, spermatogenesis and sperm capacitation, as well as in kidney physiology. In this Review, Wahab et al. discuss the urogenital roles of kisspeptin signalling, and consider the potential for kisspeptin to be used as a biomarker for the diagnosis and prognosis of urogenital carcinomas.

Neural control of micturition is a complex process, involving input from many different brain regions. In this Review, Derek Griffiths describes a simplified model of neural control of micturition that incorporates current knowledge, largely derived from functional brain imaging studies of humans and experimental animals. Consideration is also given to the effects of treatments of urinary urgency on neural control of micturition.

Penile prostheses have remained the gold-standard therapy for medically refractory erectile dysfunction (ED) since their popularization. Here, Trost and colleagues discuss the considerations for penile prosthesis placement with regard to operative techniques, adjunctive procedures, and complications, as well as device design and operative technique.

Although rare, ejaculatory duct obstruction (EDO) is a surgically correctable cause of male sexual dysfunction and male infertility due to obstructive azoospermia, and should be considered within the list of differential diagnoses for men undergoing infertility investigations. In this article, the authors discuss the anatomy, embryology and pathophysiology of EDO, and consider the current optimal diagnostic and treatment options.

Biomarkers predicting response to chemotherapy in patients with muscle-invasive bladder cancer (MIBC) have the potential to better select patients for treatment and to improve outcomes of this aggressive disease. Results from a new study bring us a step closer to individualizing treatment through use of a three-gene signature to predict response to neoadjuvant chemotherapy.

Elective pelvic nodal irradiation (EPNI) remains a controversial area in prostate cancer management. Two articles published in the International Journal of Radiation, Oncology, Biology and Physics present additional data regarding the benefits of EPNI for patients with high-risk prostate cancer, suggesting that EPNI confers no benefit in overall survival or biochemical-progression-free survival.

Radical cystectomy is the standard treatment for patients with bladder cancer, but the prognosis of patients undergoing this procedure has not changed for decades. Small steps towards improvement include better selection of high-risk T1 patients, the use of perioperative chemotherapy and, maybe, robotic cystectomy.

The development of the ureteral access sheath (UAS) has enabled substantially greater use of ureteroscopy for minimally invasive management of diseases of the upper urinary tract. Here, the authors describe the advantages and risks associated with the routine use of UAS, and the potential for use of UAS by endourologists for a wider range of applications.

Effectiveness of an innovative online psychological intervention and forum was investigated in a three-arm randomized controlled trial. Improvements in several elements of psychological distress were observed in men with prostate cancer who had access to both the intervention and the forum over a 10-week period.