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Urology

Volume 11, No 1 - Winter 2009

Volume 11, No 1 - Winter 2009

Table of Contents

The Evolution of Transdermal/Topical Overactive Bladder Therapy and Its Benefits Over Oral Therapy Treatment Update
Multiple antimuscarinic agents are available for the treatment of overactive bladder. Many of the agents have undergone reformulation in an attempt to improve patient adherence and drug tolerability. Oxybutynin evolved from an immediate-release pill to a once-daily oral preparation, and is now available as a transdermal patch and gel. This article discusses the clinical impact of oxybutynin reformulation and reviews the evolution and benefits of transdermal therapy.[Rev Urol. 2009;11(1):1-6]
Robotic Image-Guided Needle Interventions of the Prostate Technology Update
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]
The Role of Immunotherapy in Prostate Cancer: An Overview of Current Approaches in Development Treatment Review
Ongoing clinical trials provide promise for the introduction of immunotherapy into the armamentarium against prostate cancer, but the precise role for immunotherapy remains to be determined. Combinations of immunotherapies may be needed to improve the response rates and the duration of response. Investigators have begun to examine the effect of immunotherapy in combination with other standard treatment, including as an adjuvant to chemotherapy or radiotherapy and as a neoadjuvant agent before prostatectomy. Although many studies examine efficacy in men with metastatic hormone-refractory prostate cancer, there is some evidence for improved responses at earlier stages of disease: the ability of the tumor to evade the immune system may be lessened with lower tumor burden, or the immune system may already be weakened in men with later stages of disease.[Rev Urol. 2009;11(1):16-27]
Treatment of Painful Bladder Syndrome and Pelvic Organ Prolapse
Highlights of the 4th International Consultation on Incontinence, July 5-8, 2008, Paris, France[Rev Urol. 2009;11(1):28-32]
Renal Involvement by Chronic Myelomonocytic Leukemia Requiring Nephroureterectomy
Chronic monomyelocytic leukemia (CMML) is a relatively rare clonal hematologic disorder with features of myelodysplastic syndrome and myeloproliferative disease. Renal impairment from CMML is infrequent and can result from both direct (ie, infiltrative) and indirect (eg, vasculitis, infarction) mechanisms. This case report describes a patient with refractory gross hematuria requiring nephroureterectomy with diffuse involvement of the upper tract by CMML and accompanying extramedullary hematopoiesis. Underscored are the need to maintain a broad differential diagnosis for upper tract lesions in the setting of gross hematuria, and the potential need for drastic measures to control upper tract bleeding if conservative measures fail.[Rev Urol. 2009;11(1):33-37]
Pediatric Urology News and Views From the Literature
[Rev Urol. 2009;11(1):38-40]
Ejaculation Disorders News and Views From the Literature
[Rev Urol. 2009;11(1):41]
Incontinence News and Views From the Literature
[Rev Urol. 2009;11(1):41-43]