IJU this issue

Abstract

Medical treatments against metastatic bladder cancer are also important topics. A Review Article by Sio et al. (Minnesota, USA) summarized the clinical evidence for the use of platinum-based, non-platinum-based and new targeted biological agents, and reported the future directions in the treatment of metastatic bladder cancer. Although cisplatin-based regimens are the current standard, the authors discussed alternative therapies consisting of paclitaxel, gemcitabine and carboplatin, especially for cisplatin-ineligible patients. Pemetrexed and vinflunine have also shown effectiveness, whereas new targeted therapies, such as gefetinib, sorafenib and lapatinib, have not yet been effective as single agents in a relapse setting. The other Review Article by Sakakibara et al. (Sakura, Japan) deals with bladder function of patients with Parkinson's disease. They reported that the majority of patients with Parkinson's disease have overactive bladder (urinary urgency/frequency) with little or no post-void residuals, although bladder function amongst these patients alters significantly. Anticholinergic drugs are the first-line treatment, and the second-line treatment includes serotonergics, desmopressin and others. Botulinum toxin is promising, particularly in difficult cases. These aforementioned treatments are beneficial in maximizing patients' quality of life. Urinary incontinence after radical prostatectomy is a big problem for patients with prostate cancer. In this issue, two interesting studies regarding urinary incontinence after radical prostatectomy were reported. Sato et al. (Sapporo, Japan) measured the urine loss ratio using the 24-h pad test during 7 consecutive days after removal of urethral catheters, and showed that urine loss ratio values were significant predictors of continence at 12 months using logistic regression analysis. This parameter seems to be useful when we estimate future recovery of urinary continence after radical prostatectomy. In contrast, Lee and Ha (Busan, Korea) evaluated the significance of intravesical prostatic protrusion (IPP) as a predictor of early urinary continence recovery after laparoscopic radical prostatectomy. They concluded that the incidence of postoperative urinary incontinence in patients undergoing laparoscopic radical prostatectomy was markedly higher in those with larger IPP, and that IPP was correlated with the duration of postoperative urinary incontinence. Thus, IPP seems to be a predictor of severe urinary incontinence after laparoscopic radical prostatectomy, while a prospective validation of IPP is required. Another topic regarding prostate cancer is prostate-specific antigen (PSA) bounce after iodine-125 permanent implant brachytherapy for localized prostate cancer. Nishihara et al. (Fukuoka, Japan) analyzed clinical and dosimetric factors involved in PSA bounce in patients who underwent permanent implant brachytherapy for localized prostate cancer, and reported that young age and a high level of pretreatment sexual function were significant predictive factors for PSA bounce using regression analysis. They also emphasized that doctors should have a good understanding of the PSA bounce associated with brachytherapy to avoid causing undue anxiety to patients. In the field of urolithiasis, Chung et al. (Taipei, Taiwan) examined the risk of diabetes mellitus within a 5-year period among patients with nephrolithiasis undergoing percutaneous nephrolithotomy, by retrospectively comparing 304 patients who underwent percutaneous nephrolithotomy with 3040 patients with nephrolithiasis who did not undergo percutaneous nephrolithotomy. Their results showed an association between patients with nephrolithiasis who undergo a percutaneous nephrolithotomy and a subsequent diabetes mellitus diagnosis. As the results are provocative, a prospective validation study is indispensable. None declared.