Current Opinion in Urology最新文献_第10页

Medical therapy for male infertility. 男性不育症的医学治疗。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2024-10-08 DOI: 10.1097/MOU.0000000000001231

Edoardo Pozzi, Christian Corsini, Andrea Salonia

{"title":"Medical therapy for male infertility.","authors":"Edoardo Pozzi, Christian Corsini, Andrea Salonia","doi":"10.1097/MOU.0000000000001231","DOIUrl":"10.1097/MOU.0000000000001231","url":null,"abstract":"Purpose of review: To provide up-to-date evidence and clinical guidance on the role of medical therapy in the context of hormonal imbalances affecting human spermatogenesis.Recent findings: Compelling evidence has accumulated over the years regarding the role of gonadotropins, selective estrogen modulators, and aromatase inhibitors to either improve or restore spermatogenesis in men with hormonal abnormalities (e.g. hypogonadotropic/hypergonadotropic hypogonadism, hyperprolactinemia) or supraphysiologic levels (e.g. exogenous testosterone/anabolic steroid use). Despite the increasing number of studies being performed, most of the available evidence relies on small nonrandomized studies, mainly in men with hypergonadotropic hypogonadism or with history of exogenous testosterone/anabolic steroid use. As such, the efficacy of medical therapy is highly variable emphasizing the necessity of randomized clinical trials and individualized approaches.Summary: This narrative review provides clinical guidance on medical therapies for male factor infertility based on the most up-to-date evidence, focusing on treatments for hormonal abnormalities (either hypogonadotropic or hypergonadotropic hypogonadism and hyperprolactinemia) and supraphysiologic levels (and exogenous testosterone/anabolic steroid use) to improve spermatogenesis.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"157-164"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of MRI in muscle-invasive bladder cancer: an update from the last two years. 磁共振成像在肌肉浸润性膀胱癌中的作用：过去两年的最新进展。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2024-11-11 DOI: 10.1097/MOU.0000000000001249

Giovanni Luigi Pastorino, Chiara Mercinelli, Andrea Necchi

{"title":"The role of MRI in muscle-invasive bladder cancer: an update from the last two years.","authors":"Giovanni Luigi Pastorino, Chiara Mercinelli, Andrea Necchi","doi":"10.1097/MOU.0000000000001249","DOIUrl":"10.1097/MOU.0000000000001249","url":null,"abstract":"Purpose of review: Muscle invasive bladder cancer (MIBC) is aggressive and requires radical cystectomy and neoadjuvant therapy, yet over 40% of patients face recurrence. The loss of the bladder also significantly reduces quality of life. Accurate staging, crucial for treatment decisions, is typically done through transurethral resection (TURBT), but inconsistencies in pathology affect diagnosis in 25% of cases. MRI is the most precise imaging method for evaluating local tumor invasiveness. This review discusses recent advances in MRI for staging MIBC and predicting responses to neoadjuvant therapy.Recent findings: Vesical imaging - reporting and data system (VI-RADS) accuracy may improve if combined with ADC maps and tumor contact length, while a bi-parametric MRI approach without contrast could reduce side effects without losing diagnostic precision, though evidence is mixed. VI-RADS shows promise in predicting neoadjuvant therapy responses, and the new nacVI-RADS score is in development. Non-Gaussian diffusion-weighted imaging techniques and machine learning could enhance accuracy but need more integration with mpMRI. VI-RADS may assist in evaluating responses in bladder-sparing regimens. Urodrill, an MRI-guided biopsy, aims to replace diagnostic TURBT but needs more accuracy data.Summary: MRI in MIBC is evolving, offering potential for accurate local staging and reduced side effects by avoiding TURBT. Predicting neoadjuvant treatment response could guide personalized treatment and bladder preservation. Larger trials are needed to validate these findings.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"165-170"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is there a role for neoadjuvant therapies followed by radical cystectomy in oligometastatic bladder cancer? 新辅助治疗后根治性膀胱切除术在少转移性膀胱癌中是否有作用？

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2025-01-16 DOI: 10.1097/MOU.0000000000001261

Anna Cadenar, Stefano Mancon, Shahrokh F Shariat, David D'Andrea

{"title":"Is there a role for neoadjuvant therapies followed by radical cystectomy in oligometastatic bladder cancer?","authors":"Anna Cadenar, Stefano Mancon, Shahrokh F Shariat, David D'Andrea","doi":"10.1097/MOU.0000000000001261","DOIUrl":"10.1097/MOU.0000000000001261","url":null,"abstract":"Purpose of review: This review explores the potential role of neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) for oligometastatic bladder cancer (OMBC) treatment. We focused on extrapolating evidence from studies including lymph node-positive only and metastatic bladder cancer to address the key challenges and therapeutic strategies for OMBC.Recent findings: Current evidence for NAC and RC in OMBC is limited, with most data derived from studies in locally advanced bladder cancer. NAC has shown efficacy in downstaging and improving survival in patients with locally advanced disease, but its benefits in OMBC remain speculative. Additionally, diagnostic uncertainties, particularly regarding the inclusion of pelvic lymph nodes and the role of FDG-PET/CT, pose significant challenges to accurate staging and treatment decisions. Recent studies highlight the potential of metastasis-directed therapy, but uncertainties remain on patient selection and treatment protocols for OMBC.Summary: There is need for prospective studies to evaluate neoadjuvant systemic treatments and RC specifically in OMBC. Moreover, resolving current diagnostic challenges is crucial to avoid undertreatment due to inaccurate staging. Until more concrete evidence emerges, changes to standard treatment protocols should be approached with caution and offered only within trials.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"189-193"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advancing men's health: insights and innovations. 促进男性健康：见解与创新。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2025-02-02 DOI: 10.1097/MOU.0000000000001256

Premal Patel, Shahrokh F Shariat

引用次数: 0

The changing landscape of nonobstructive azoospermia. 不断变化的非梗阻性无精子症。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2024-11-27 DOI: 10.1097/MOU.0000000000001252

Laurianne Rita Garabed, Ryan Flannigan

{"title":"The changing landscape of nonobstructive azoospermia.","authors":"Laurianne Rita Garabed, Ryan Flannigan","doi":"10.1097/MOU.0000000000001252","DOIUrl":"10.1097/MOU.0000000000001252","url":null,"abstract":"Purpose of review: This article aims to describe new developments in the field of nonobstructive azoospermia biology, diagnostics, biomarkers, and therapeutic strategies.Recent findings: Recent studies have investigated the molecular underpinnings of cellular dysfunction that is contributing to spermatogenic dysfunction and findings suggest abnormalities across both somatic and germ cells. Biomarkers to predict the chances of sperm retrieval are being explored utilizing cell free (cf) DNA and RNA from various body fluids, in addition to a full range of transcripts and epigenetics within seminal fluid. Various approaches are being explored to optimize sperm identification from surgical specimens including microfluidic and machine learning approaches. Finally, approaches to regenerating sperm production from males with nonobstructive azoospermia are evolving to include various 3-dimensional culture techniques with integration of computational modeling.Summary: The landscape of nonobstructive azoospermia biomarkers, molecular underpinnings, technological approaches to more reliably identify sperm and novel regenerative therapeutic strategies are likely to transform the field of male reproduction in years to come.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"127-134"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2025-02-02 DOI: 10.1097/MOU.0000000000001259

引用次数: 0

Contemporary nonsurgical management of Peyronie's disease. 当代佩罗尼氏病的非手术治疗。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-03-01 Epub Date: 2024-12-26 DOI: 10.1097/MOU.0000000000001255

Alexandr M Pinkhasov, David Y Yang, Elise Tentis, Matthew Ziegelmann

{"title":"Contemporary nonsurgical management of Peyronie's disease.","authors":"Alexandr M Pinkhasov, David Y Yang, Elise Tentis, Matthew Ziegelmann","doi":"10.1097/MOU.0000000000001255","DOIUrl":"10.1097/MOU.0000000000001255","url":null,"abstract":"Purpose of review: Peyronie's disease characterizes a condition in which there is angular curvature of the penis. We know that the most patients with Peyronie's disease will not have spontaneous resolution of their penile curvature. As such, patients who desire treatment can elect for either surgical or nonsurgical therapy. Herein, we discuss the contemporary nonsurgical management options for Peyronie's disease.Recent findings: Nonsurgical management options for Peyronie's disease include oral therapy, intra-lesional injections, and penile traction therapy. At the time of this review, there is essentially no high-level evidence demonstrating any benefit for oral therapy. Penile traction therapy has evolved over the past decade with second-generation devices demonstrating strong efficacy and more convenient treatment regimens. Intra-lesional options include collagenase Clostridium histolyticum (CCH), verapamil, and interferon alpha-2b. The IMPRESS trial garnered the strongest level of evidence (two randomized, double-blind, placebo-controlled trials) to support the safety and efficacy of CCH. Verapamil is an option supported by several urological societies; however, the evidence supporting its efficacy is inconsistent between several notable series and randomized studies. IFN alpha 2b can produce modest improvement in curvature, however, is not available for use in North America.Summary: Herein, we will discuss notable advances in nonsurgical management of Peyronie's disease.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"135-141"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of innovations in advancing urologic oncologic patient care. 在推进泌尿肿瘤患者护理创新的作用。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/MOU.0000000000001236

Shahrokh Shariat, Jeremy Teoh

引用次数: 0

Liquid biomarkers in prostate cancer: recent advancements and future directions. 前列腺癌液体生物标记物：最新进展与未来方向。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-01-01 Epub Date: 2024-05-06 DOI: 10.1097/MOU.0000000000001188

Chris Ho-Ming Wong, Ivan Ching-Ho Ko, Chi Fai Ng

{"title":"Liquid biomarkers in prostate cancer: recent advancements and future directions.","authors":"Chris Ho-Ming Wong, Ivan Ching-Ho Ko, Chi Fai Ng","doi":"10.1097/MOU.0000000000001188","DOIUrl":"10.1097/MOU.0000000000001188","url":null,"abstract":"Purpose of review: Traditional diagnostic approaches of prostate cancer like PSA are limited by high false-positive rates and insufficient capture of tumour heterogeneity, necessitating the development of more precise tools. This review examines the latest advancements in liquid biomarkers for prostate cancer, focusing on their potential to refine diagnostic accuracy and monitor disease progression.Recent findings: Liquid biomarkers have gained prominence because of their minimally invasive nature and ability to reflect the molecular characteristics of prostate cancer. Circulating tumour cells provide insight into tumour cell dissemination and are indicative of aggressive disease phenotypes, with single-cell analyses revealing genomic instability and treatment resistance. Circulating tumour DNA offers real-time tumour genomic information, aiding in treatment decision-making in advanced prostate cancer, where it has been associated with clinical progression. MicroRNAs act as oncogenes or tumour suppressors and exhibit diagnostic and prognostic potential; however, their clinical utility is constrained by the lack of consistent validation. Extracellular vesicles contain tumour-derived biomolecules, with specific proteins demonstrating prognostic relevance. Applications of these markers to urinary testing have been demonstrated.Summary: Liquid biomarkers show potential in refining prostate cancer management. Future research should aim to integrate these biomarkers into a cohesive framework in line with precision medicine principles.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":"3-12"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimizing overtreatment and maximizing oncologic outcomes in upper tract urothelial carcinoma. 减少过度治疗和提高上尿路上皮癌的肿瘤预后。

IF 2.1 3区医学

Current Opinion in Urology Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1097/MOU.0000000000001238

Ali H Zahalka, Vitaly Margulis

{"title":"Minimizing overtreatment and maximizing oncologic outcomes in upper tract urothelial carcinoma.","authors":"Ali H Zahalka, Vitaly Margulis","doi":"10.1097/MOU.0000000000001238","DOIUrl":"10.1097/MOU.0000000000001238","url":null,"abstract":"Purpose of review: An update on the latest advances in the management of upper tract urothelial carcinoma (UTUC), with an emphasis on strategies to optimize oncologic outcomes while minimizing overtreatment.Recent findings: Recent high-quality trials have changed the landscape of UTUC treatment. Emerging tools including 3D histology and measurement of cell free tumor DNA may improve diagnostic accuracy of disease grading and staging, and be used in monitoring treatment response. Novel therapies show promise of reducing low-grade UTUC disease recurrence at the cost of significant side-effects. Platinum-based neoadjuvant chemotherapy in high-grade/muscle-invasive disease showed complete pathological response in a subset of patients, but difficult to predict responders. Adjuvant platinum-based chemotherapy exhibited a clear survival benefit, but immunotherapy did not, suggesting possible overtreatment with these agents. Molecularly-targeted therapies in metastatic UTUC have shown the greatest recent oncologic advances, but exhibit a high adverse event-rate.Summary: Low-grade UTUC has the potential for overtreatment, as it exhibits low metastatic-potential and excellent survival. For high-grade and advanced-stage UTUC, these carry high mortality rates and require more aggressive treatment, but studies are limited by inaccurate grading and staging which can lead to overtreatment especially in the neoadjuvant setting. Emerging technologies will help improve diagnostic accuracy and noninvasive monitoring of treatment response.","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":"35 1","pages":"96-102"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0