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Urology

Volume 14, No 1/2 - 2012

Volume 14, No 1/2 - 2012

Table of Contents

LHRH Agonists for the Treatment of Prostate Cancer: 2012 Management Review
The most recent guidelines on prostate cancer screening from the American Urological Association (2009), the National Comprehensive Cancer Network (2011), and the European Association of Urology (2011), as well as treatment and advances in disease monitoring, have increased the androgen deprivation therapy (ADT) population and the duration of ADT usage as the first-line treatment for metastatic prostate cancer. According to the European Association of Urology, gonadotropin-releasing hormone (GnRH) agonists have become the leading therapeutic option for ADT because they avoid the physical and psychological discomforts associated with orchiectomy. However, GnRH agonists display several shortcomings, including testosterone (T) surge (“clinical flare”) and microsurges. T surge delays the intended serologic endpoint of T suppression and may exacerbate clinical symptoms. Furthermore, ADT manifests an adverse-event spectrum that can impact quality of life with its attendant well-documented morbidities. Strategies to improve ADT tolerability include a holistic management approach, improved diet and exercise, and more specific monitoring to detect and prevent T depletion toxicities. Intermittent ADT, which allows hormonal recovery between treatment periods, has become increasingly utilized as a methodology for improving quality of life while not diminishing chronic ADT efficacy, and may also provide healthcare cost savings. This review assesses the present and potential future role of GnRH agonists in prostate cancer and explores strategies to minimize the adverse-event profile for patients receiving ADT. [ Rev Urol. 2012;14(1/2):1-12 doi:10.3909/riu0547 ] © 2012 MedReviews®, LLC
Active Surveillance for Small Renal Masses Management Update
Small renal masses (SRMs; # 4 cm in dimension) have rapidly risen in incidence in recent decades and pose an increasingly common management dilemma in urology. SRMs are biologically heterogeneous and a wide variety of treatments exist with favorable oncologic outcomes. Active surveillance (AS) has emerged as a viable option for those not desiring surgery or those who are suboptimal candidates for surgery, with < 2% of patients progressing to metastatic disease in retrospective and prospective studies. This article reviews the current data regarding AS for SRM, operational considerations for an AS program, and criteria for safely selecting patients for this treatment strategy. [ Rev Urol. 2012;14(1/2):13-19 doi: 10.3909/riu0545] © 2012 MedReviews®, LLC
Radical Retropubic Prostatectomy: Comparison of the Open and Robotic Approaches for Treatment of Prostate Cancer Treatment Review
Radical prostatectomy represents the standard of care for surgical treatment of clinically localized prostate cancer. First described in 1904, the operation became widely performed only after advances in diagnostic and surgical techniques occurred later in the century. Over time, open retropubic radical prostatectomy (RRP) became the most common operation for prostate cancer, and excellent long-term survival outcomes have been reported. More recently, minimally invasive techniques such as the robotic-assisted laparoscopic radical prostatectomy (RALRP) were introduced. Despite a lack of prospectively collected, long-term data supporting its use, RALRP has overtaken RRP as the most frequently performed prostate cancer operation in the United States. This article uses currently available data to compare oncologic, functional, and quality-of-life outcomes associated with both the open and robotic approaches to radical prostatectomy. [ Rev Urol. 2012;14(1/2):20-27 doi:10.3909/riu0552] © 2012 MedReviews®, LLC
Innovation in Endourology and Minimally Invasive Surgery Highlights From the 29th World Congress of Endourology and SWL 2011, November 30-December 3, 2011, Kyoto, Japan
[ Rev Urol. 2012;14(1/2):28-30 doi: 10.3909/riu0554] © 2012 MedReviews®, LLC
Adult Wilms’ Tumor With a Unique Presentation of High-Grade Fever, Photophobia, and Headache
Wilms’ tumor is the second most common tumor in children, accounting for 6% to 7% of all childhood tumors. However, in adults, it is a rare occurrence. The true incidence of adult Wilms’ tumor is difficult to ascertain because of its rarity in the adult population. A review of literature demonstrates that fewer than 300 cases have been reported worldwide. Treatment guidelines in adults have not been established, although reported prognosis is worse for adults compared with children because the disease is more advanced in adults at the time of diagnosis. Reported here is a case of adult Wilms’ tumor presenting as high-grade fever and abnormal laboratory values. [ Rev Urol. 2012;14(1/2):31-34 doi: 10.3909/riu0541] © 2012 MedReviews®, LLC
Pelvic Surgeons Caught in the Meshes of the Law Pelvic Organ Prolapse
[Rev Urol. 2012;14(1/2):35-36 doi: 10.3909/riu0543] © 2012 MedReviews®, LLC
Urodynamics in Children Pediatric Urology
[Rev Urol. 2012;14(1/2):36-38 doi: 10.3909/riu0549] © 2012 MedReviews®, LLC
Congenital Bladder Abnormalities Pediatric Urology
[Rev Urol. 2012;14(1/2):38 doi: 10.3909/riu0550] © 2012 MedReviews®, LLC
Notice of Duplicate Publication
[ Rev Urol. 2012;14(1/2):40 doi: 10.3909/riu0140122012 ] © 2012 MedReviews®, LLC