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Editorials (March)
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Are All Alpha-Blockers Created the Same?
Wednesday, 01 March 2006
In the next decade, the number of men who will consult for lower urinary tract symptoms (LUTS), often in connection with benign prostatic hyperplasia (BPH), will increase for two reasons: the population is aging and fewer and fewer men will consider LUTS as an inevitable mark of old age and accept this bothersome condition without seeking treatment. We should also expect continuity in the current management trend diminishing surgical intervention; medical therapy will take a more prominent role.
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Prostate Biopsy and Optimization of Cancer Yield
Wednesday, 01 March 2006
It is hard to imagine practicing urology and urologic pathologic today without prostate-specific antigen (PSA) and multiple thin-bore needle biopsies, yet these advances only became available in the past 18 years. The old large-bore needles provided considerably more tissue for the pathologist to examine, but suffered from compression artifact on the edges and a small but significant risk of needle tracking of cancer; both problems are circumvented with the smaller-bore biopsy needles used today.
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Tachykinins: Role in Detrusor Overactivity?
Wednesday, 01 March 2006
The nerves of the lower urinary tract synthetize, store, and release many neuropeptides, including tachykinins, i.e., substance P (SP), neurokinin A (NKA), and neurokinin B (NKB) [1]. It is generally accepted that tachykinins have an important role in afferent signaling from the bladder, and that they may be involved in different pathologies in the lower urinary tract.
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Twenty Years of Urotherapy in Children: What Have We Learned?
Wednesday, 01 March 2006
Starting in the late 1980s and originating in Scandinavia, ‘‘urotherapy’’ for children with voiding problems found its way throughout the medical world. ‘‘Urotherapy’’ means nonsurgical, nonpharmacologic treatment of lower urinary tract function and can be defined as a bladder re-education or rehabilitation program aiming at correction of filling and voiding difficulties. It is thus synonymous with the term ‘‘lower urinary tract rehabilitation,’’ frequently used for adults [1].
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PSA Velocity and Prostate Cancer Detection: The Absence of Evidence is not the Evidence of Absence
Wednesday, 01 March 2006
The article by Schröder et al. [1] touches on an important topic and shows evidence that adds to the current confusion about the role of prostatespecific antigen velocity (PSAV) in prostate cancer early detection and screening: in a prescreened population for prostate cancer (second round) once the serum (total) PSA has reached the cut-off value of 4 ng/ml, the PSAV adds no new information about the presence of a cancer. This is disappointing, considering the urgent need to improve the discriminative power of serum total PSA to separate subjects with prostate cancer from those without.
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