IJU this issue

Abstract

This issue deals with a wide range of clinical topics of urology, and contains two Review Articles, nine Original Articles and three Urological Notes. Pelvic fractures from high-energy blunt force trauma can cause injury to the posterior urethra, known as pelvic fracture urethral injury (PFUI). PFUI should be suspected if a patient with pelvic trauma has blood at the meatus and/or difficulty voiding, and retrograde urethrography should be carried out if the patient is stable. Once urethral injury is confirmed, urinary drainage should be established promptly by placement of a suprapubic tube or primary realignment of the urethra over a urethral catheter. In this issue, the key factors in the management of PFUI are reviewed and current topics are summarized by Horiguchi (Tokorozawa, Japan). Although PFUIs are relatively rare, this review is considered very useful when we treat PFUI. In recent years, the induction of novel agents, including molecular-targeted agents and immune checkpoint inhibitors, have dramatically changed therapeutic options and their outcomes for metastatic renal cell carcinoma. Several prognostic models based on the data of patients with metastatic renal cell carcinoma treated with targeted agents or cytokine therapy have been useful in real clinical practice. In this review article, Teishima et al. (Hiroshima, Japan) discusses the conventional prognostic models and clinical factors, and recent advances of the identification of some of the most promising molecules as novel biomarkers for metastatic renal cell carcinoma. Type 2 diabetes mellitus (DM) is a chronic metabolic disease. It is known that DM has morbid effects on multiple organs, such as the peripheral nerves, retina, kidney and so on. Diabetic cystopathy is one of the common diabetic complications. Majima et al. (Nagoya, Japan) analyzed sequential changes of diabetic cystopathy based on urodynamic data in patients with DM. They demonstrate that diabetes patients have diverse progressive bladder dysfunction according to the diabetes stage. They also indicate that optimal screening program is necessary to detect and manage diabetic cystopathy at an early stage. The above results are important when we check patients with DM. Skeletal-related events (SREs) induced by bone metastasis (BM) can result in reduced quality of life and an increase in healthcare burdens. Therefore, preventing SREs is important for the management of patients with BM. Owari et al. (Kashihara, Japan) evaluated the clinical benefit of bone-modifying agents and identified the risk factors of SREs in patients with genitourinary cancer with newly diagnosed BM. They demonstrate that early treatment with bone-modifying agents should be considered, especially for patients with bone pain and elevated alkaline phosphatase levels, to prevent SREs in patients with genitourinary cancer with BM. The above results are helpful in considering when we start bone-modifying agents to patients with genitourinary cancer with BM. Transrectal ultrasound (TRUS) prostate biopsy is widely used to diagnose prostate cancer. The frequency of infective complications was reported to be 0.83% in Japan, and the major pathogen was Escherichia coli. Hiyama et al. (Sapporo, Japan) evaluated a regimen of targeted prophylaxis using rectal swab culture in patients undergoing TRUS-guided prostate biopsy, and investigate the characteristics of isolated fluoroquinolone-resistant Escherichia coli. They demonstrate that targeted antimicrobial prophylaxis in patients undergoing TRUS-guided prostate biopsy can be associated with reducing severe infectious complications caused by fluoroquinolone-resistant Escherichia coli. None declared.