Volume 14 Issue 4, April 2017

Transvaginal mesh for pelvic organ prolapse (POP) is more controversial than ever. The largest randomized trial yet suggests transvaginal mesh or grafts are of no benefit in primary POP repair. Furthermore, a population study looks back at complication rates from pelvic floor mesh surgery over the past two decades.

Understanding risk factors for prostate cancer is an important step towards personalized, risk-adapted early detection and prevention. Epidemiological studies, which are commonly used to identify risk factors, are prone to detection bias. This bias could substantially affect the observed relationship between putative risk factors and prostate cancer diagnosis.

Fournier's gangrene is a life-threatening urological emergency, which requires prompt treatment with fluid resuscitation, debridement, and reconstruction. In this Review, Hagedorn and Wessells describe the contemporary management of Fournier's gangrene, and discuss prognostic tools, therapeutics, and follow-up care of this rare but debilitating disorder.

Large-scale, next-generation sequencing collaborations have identified drivers and vulnerabilities of urothelial carcinoma. In this Review, the authors discuss the mutational landscape of urothelial carcinoma, including specific mutations in pathways and driver genes and describe how the next generation of therapies will be based on patient-specific targetable mutations observed in individual tumours.

Prostate cancer is typically diagnosed in men ≥65 years of age, many of whom have one or more comorbidities, often including cardiovascular comorbidities, thus highlighting a need to understand the risks of cardiovascular toxicities associated with prostate cancer treatments. In this Review, the authors describe the evidence linking widely used treatments of prostate cancer, including androgen deprivation therapies, chemotherapies and targeted therapies with cardiovascular adverse events.

Intravesical immunotherapy using BCG is the treatment approach for patients with high-risk and intermediate-risk non-muscle-invasive bladder cancer (NMIBC). However, recurrence and progression are a problem. In this Review, an expert group of authors from the International Bladder Cancer Group discuss the treatment options available after BCG failure and provide recommendations for optimal management of these patients.