Articles in 2015

2015 has seen advances in various bladder conditions. MicroRNAs might become therapeutic targets, the MAPP network characterized central neurological changes in chronic pelvic pain syndrome, and urologists were reminded to consider cognitive effects of long-term anticholinergics use. A study of obstetric vesicovaginal fistula repair shows how evidence-based research might improve public health in poorly resourced countries.

Men of African origin are disproportionately affected by prostate cancer; in this Review, McGinley and colleagues discuss the disparities in treatment, the cancer-survivorship experience, and quality-of-life outcomes, as well as aspects that might contribute to these differences including socioeconomic, cultural, and genetic factors.

Androgen deprivation combined with external beam radiotherapy improves the overall survival of patients with localized prostate cancer but might be associated with adverse effects that influence their health and quality of life. When considering this medication, clinicians must be aware of the increased risk of cardiac mortality in patients with moderate or severe comorbidity.

Mirabegron has been shown to cause relaxation of the isolated mouse urethra, partly through blockade of α_1A-adrenoceptors and α_1D-adrenoceptors. However, although this effect might be an interesting pharmacological in vitro observation, it seems to have no relevance for the clinical use of mirabegron in the treatment of the overactive bladder.

The interaction between tumour cells and their microenvironment has an important role in cancer pathogenesis. Alfano et al. review how dysregulation of the extracellular matrix and microbiota associated with the human epithelium might influence the development and progression of urothelial carcinomas.

The introduction of a targeted approach to treatment of prostate cancer requires the approval of novel medical devices. Here, authors describe the regulatory pathways that govern the approval of novel medical devices for clinical use. Owing to differences in legislation, these approval pathways differ substantially between the European Union and the USA, often resulting in patients receiving different treatments for prostate cancer in Europe, compared with the USA.

In 2015, population-based studies in patients with urinary stones informed us of the changing trends in contemporary stone management and identified areas for improvement. Although meta-analyses aim to provide the highest level of evidence, a randomized controlled trial of medical expulsive therapy challenged current paradigms and was the defining publication of the year.

The development of novel antiandrogens and androgen synthesis inhibitors has improved the outcomes of patients with prostate cancer; however, the issue of resistance to these therapies has also emerged. In light of these developments, unexpected interactions between these novel therapies and glucocorticoid signalling have been observed. Here, authors describe current knowledge of androgen–glucocorticoid signalling as a cause of drug resistance and disease progression in patients with prostate cancer.