IJU this issue

Abstract

This month's issue covers a wide range of topics, including one Review Article, seven Original Articles, two Urological Notes and two Letters to the Editor. The Review Article by Jinzaki et al. (Tokyo, Japan) deals with the role of computed tomography (CT) urography for imaging of upper tract urothelial carcinoma. For some time, CT urography has replaced intravenous urography for first-line imaging of patients with a risk of upper tract urothelial carcinoma. However, CT urography has a number of limitations. This Review Article summarizes the present status, issues and future perspective of CT urography in clinical practice, and will be informative for readers. The Original Article by Schmid et al. (Boston, USA) reports a previously little-known adverse effect of gonadotropin-releasing hormone (GnRH) agonists. The authors analyzed a cohort of 52 905 patients with localized prostate cancer included in the SEER database, and found that increased administration of GnRH agonists was associated with a higher risk of community-acquired respiratory tract infections. The relationship between androgen deprivation therapy and respiratory infections had drawn attention since the first report by Chung et al. from Taiwan (PLoS ONE 2014). Contrary to that report, however, Schmid et al. detected no relationship between bilateral orchiectomy (surgical androgen deprivation therapy) and respiratory events. Whether or not GnRH agonists really increase the risk of respiratory infection, and whether there is a case for surgical androgen deprivation therapy and GnRH antagonists is an interesting issue. The Original Article by Iremashvili et al. (Miami, USA) provides somewhat intriguing and thought-provoking information on active surveillance (AS) of prostate cancer. The authors showed that pre- and post-diagnostic prostate-specific antigen kinetic parameters, such as prostate-specific antigen velocity and doubling time, did not add predictive value in terms of disease progression during AS. Prostate-specific antigen kinetics have been considered a predictor of disease progression during AS, and are still widely used by many urologists, as stated in the Editorial Comment. So what should we use as a reliable predictor of disease progression during AS? Tips and hints can be found in the text and Editorial Comment. The Original Article by Naitoh et al. (Kyoto, Japan) introduces the surgical procedure of transvesical laparoscopic cross-trigonal ureteral reimplantation for double renal pelvis and ureter with or without ureterocele. Transvesical laparoscopic cross-trigonal ureteral reimplantation itself was reported over 10 years ago, and the authors are the first to have applied it to double renal pelvis and ureter along with bladder reconstruction for ureterocele. Although this procedure might be somewhat challenging, the surgical technique is described in detail. Laparoscopic surgeons are encouraged to consider this minimally-invasive surgical procedure. The Urological Note by Krabbe and Lotan (Dallas, USA) provides convincing information. The authors found that the overall risk of lung cancer in bladder cancer patients who participated in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and National Lung Cancer Screening Trial was 4.1–5.0%, being higher than the overall incidence of lung cancer in the National Lung Cancer Screening Trial (3.9%), and far exceeding rates in the general population. Therefore, they suggest that patients newly diagnosed with bladder cancer should be screened for lung cancer using low-dose CT of the chest, although the current bladder cancer guidelines do not make recommendations regarding screening for other cancers. Considering that bladder cancer and lung cancer have the same risk factors, including smoking and arsenic in drinking water, and lung cancer is the most common cause of death from cancer, as stated in the Editorial Comment, the authors might be right. None declared.