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Urology: Current Trends and Recent Innovations

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Key Topics in Surgical Research and Methodology

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Abstract

This chapter reflects on hot topics of uro-logical research, a speciality which has often been at the forefront of surgical innovation.

Relatively recently, we have seen widespread uptake in robotic platforms, which has enhanced the minimally invasive approach for radical treatment of bladder, prostate and renal cancer. Focally delivered energy sources, such as cryotherapy and high-intensity focal ultrasound, are an exciting prospect even as “lessinva-sive” treatments but they need to be combined with improved real-time imaging modalities. The combination of diagnostic-enhancing technology with endo-scopic techniques, such as hexaminolevulinate (HAL) cystoscopy and endocytoscopy, looks to improve the management of superficial bladder cancer. The diagnosis, staging and prognostic stratification of urologi-cal malignancy will be improved through advances in both imaging modalities and molecular and biological markers of disease.

These and other areas are discussed in the light of recent research and the areas of future innovation highlighted.

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References

  1. Novick AC (2004) Laparoscopic and partial nephrectomy. Clin Cancer Res 10:6322S–6327S

    Article  PubMed  Google Scholar 

  2. Honeck P, Wendt-Nordahl G, Bolenz C et al (2008) Hemostatic properties of four devices for partial nephrec-tomy: a comparative ex vivo study. J Endourol 22:1071–1076

    Article  PubMed  Google Scholar 

  3. Breda A, Stepanian SV, Lam JS et al (2007) Use of haemostatic agents and glues during laparoscopic partial nephrec-tomy: a multi-institutional survey from the United States and Europe of 1347 cases. Eur Urol 52:798–803

    Article  PubMed  Google Scholar 

  4. Deane LA, Lee HJ, Box GN et al (2008) Robotic versus standard laparoscopic partial/wedge nephrectomy: a comparison of intraoperative and perioperative results from a single institution. J Endourol 22:947–952

    Article  PubMed  Google Scholar 

  5. Rogers CG, Singh A, Blatt AM et al (2008) Robotic partial nephrectomy for complex renal tumors: surgical technique. Eur Urol 53:514–521

    Article  PubMed  Google Scholar 

  6. Finley DS, Beck S, Box G et al (2008) Percutaneous and laparoscopic cryoablation of small renal masses. J Urol 180:492–498; discussion 498

    Article  PubMed  Google Scholar 

  7. Weight CJ, Kaouk JH, Hegarty NJ et al (2008) Correlation of radiographic imaging and histopathology following cryoablation and radio frequency ablation for renal tumors. J Urol 179:1277–1281; discussion 1281–1283

    Article  PubMed  Google Scholar 

  8. Zagoria RJ, Traver MA, Werle DM et al (2007) Oncologic efficacy of CT-guided percutaneous radiofrequency ablation of renal cell carcinomas. AJR Am J Roentgenol 189:429–436

    Article  PubMed  Google Scholar 

  9. Wu F, Wang ZB, Chen WZ et al (2003) Preliminary experience using high intensity focused ultrasound for the treatment of patients with advanced stage renal malignancy. J Urol 170:2237–2240

    Article  PubMed  Google Scholar 

  10. Phillips CK, Taneja SS (2004) The role of lymphadenec-tomy in the surgical management of renal cell carcinoma. Urol Oncol 22:214–223; discussion 223–224

    Article  PubMed  Google Scholar 

  11. O'Brien MF, Russo P, Motzer RJ (2008) Sunitinib therapy in renal cell carcinoma. BJU Int 101:1339–1342

    Article  PubMed  Google Scholar 

  12. National Institute for Health and Clinical Excellence (2005) Guidance on cancer services, improving outcomes in uro-logical cancers, the manual. Available at http://www.nice.org.uk/nicemedia/pdf/Urological_Manual.pdf

  13. Wilt TJ, MacDonald R, Rutks I et al (2008) Systematic review: comparative effectiveness and harms of treatments for clinically localized prostate cancer. Ann Intern Med 148:435–448

    Article  PubMed  Google Scholar 

  14. Rassweiler J, Hruza M, Teber D et al (2006) Laparoscopic and robotic assisted radical prostatectomy—critical analysis of the results. Eur Urol 49:612–624

    Article  PubMed  Google Scholar 

  15. Miller J, Smith A, Kouba E et al (2007) Prospective evaluation of short-term impact and recovery of health related quality of life in men undergoing robotic assisted laparoscopic radical prostatectomy versus open radical prostatectomy. J Urol 178:854–858; discussion 859

    Article  PubMed  Google Scholar 

  16. Ficarra V, Cavalleri S, Novara G et al (2007) Evidence from robot-assisted laparoscopic radical prostatectomy: a systematic review. Eur Urol 51:45–55; discussion 56

    Article  PubMed  Google Scholar 

  17. Berryhill R Jr, Jhaveri J, Yadav R et al (2008) Robotic prostatectomy: a review of outcomes compared with laparo-scopic and open approaches. Urology 72:15–23

    Article  PubMed  Google Scholar 

  18. Blute ML (2008) Radical prostatectomy by open or laparo-scopic/robotic techniques: an issue of surgical device or surgical expertise? J Clin Oncol 26:2248–2249

    Article  PubMed  Google Scholar 

  19. Tooher R, Swindle P, Woo H et al (2006) Laparoscopic radical prostatectomy for localized prostate cancer: a systematic review of comparative studies. J Urol 175:2011–2017

    Article  PubMed  Google Scholar 

  20. Touijer K, Guillonneau B (2006) Laparoscopic radical prostatectomy: a critical analysis of surgical quality. Eur Urol 49:625–632

    Article  PubMed  Google Scholar 

  21. Touijer K, Eastham JA, Secin FP et al (2008) Comprehensive prospective comparative analysis of outcomes between open and laparoscopic radical prostatectomy conducted in 2003 to 2005. J Urol 179:1811–1817; discussion 1817

    Article  PubMed  Google Scholar 

  22. Eggener SE, Guillonneau B (2008) Laparoscopic radical prostatectomy: ten years later, time for evidence-based foundation. Eur Urol 54:4–7

    Article  PubMed  Google Scholar 

  23. Menon M, Tewari A, Baize B et al (2002) Prospective comparison of radical retropubic prostatectomy and robotassisted anatomic prostatectomy: the Vattikuti Urology Institute experience. Urology 60:864–868

    Article  PubMed  Google Scholar 

  24. Ahlering TE, Woo D, Eichel L et al (2004) Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes. Urology 63:819–822

    Article  PubMed  Google Scholar 

  25. Menon M, Shrivastava A, Tewari A (2005) Laparoscopic radical prostatectomy: conventional and robotic. Urology 66:101–104

    Article  PubMed  Google Scholar 

  26. Smith JA Jr, Chan RC, Chang SS et al (2007) A comparison of the incidence and location of positive surgical margins in robotic assisted laparoscopic radical prostatectomy and open retropubic radical prostatectomy. J Urol 178:2385–2389; discussion 2389–2390

    Article  PubMed  Google Scholar 

  27. Guillonneau BD (2005) Laparoscopic versus robotic radical prostatectomy. Nat Clin Pract Urol 2:60–61

    Article  PubMed  Google Scholar 

  28. Descazeaud A, Peyromaure M, Zerbib M (2007) Will robotic surgery become the gold standard for radical prostatectomy? Eur Urol 51:9–11

    Article  PubMed  Google Scholar 

  29. National Institute for Health and Clinical Excellence. Prostate cancer: full guidance 2008. Available at http://www.nice.org.uk/nicemedia/pdf/CG58FullGuideline.pdf

  30. Bott SRJ, Hindley RG, Abdul-Rahman A et al (2008) Are the characteristics of prostate cancer amenable to focal therapy? BJU Int 101:1–16

    Google Scholar 

  31. Braeckman J, Autier P, Garbar C et al (2008) Computer-aided ultrasonography (HistoScanning): a novel technology for locating and characterizing prostate cancer. BJU Int 101:293–298

    Article  PubMed  Google Scholar 

  32. Ohigashi T, Kozakai N, Mizuno R et al (2006) Endocytoscopy: novel endoscopic imaging technology for in-situ observation of bladder cancer cells. J Endourol 20:698–701

    Article  PubMed  Google Scholar 

  33. Bryan RT, Billingham LJ, Wallace DM (2008) Narrow-band imaging flexible cystoscopy in the detection of recurrent urothelial cancer of the bladder. BJU Int 101:702–705; discussion 705–706

    Article  PubMed  Google Scholar 

  34. Fradet Y, Grossman HB, Gomella L et al (2007) A comparison of hexaminolevulinate fluorescence cystoscopy and white light cystoscopy for the detection of carcinoma in situ in patients with bladder cancer: a phase III, multicenter study. J Urol 178:68–73; discussion 73

    Article  PubMed  Google Scholar 

  35. Haber GP, Crouzet S, Gill IS (2008) Laparoscopic and robotic assisted radical cystectomy for bladder cancer: a critical analysis. Eur Urol 54:54–62

    Article  PubMed  Google Scholar 

  36. Huang J, Lin T, Xu K et al (2008) Laparoscopic radical cys-tectomy with orthotopic ileal neobladder: a report of 85 cases. J Endourol 22:939–946

    Article  PubMed  Google Scholar 

  37. Murphy DG, Challacombe BJ, Elhage O et al (2008) Robotic-assisted laparoscopic radical cystectomy with extracorporeal urinary diversion: initial experience. Eur Urol 54:570–580

    Article  PubMed  Google Scholar 

  38. Institute of Cancer Research (2008) Selective bladder preservation against radical excision (cystectomy) — SPARE. Available at http://www.icr.ac.uk/research/research_sections/clinical_trials/clinical_trials_list/7561.shtml

  39. Smith Y, Hadway P, Biedrzycki O et al (2007) Reconstructive surgery for invasive squamous carcinoma of the glans penis. Eur Urol 52:1179–1185

    Article  PubMed  Google Scholar 

  40. Hadway P, Smith Y, Corbishley C et al (2007) Evaluation of dynamic lymphoscintigraphy and sentinel lymph-node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma. BJU Int 100:561–565

    Article  PubMed  Google Scholar 

  41. Schiffer E (2007) Biomarkers for prostate cancer. World J Urol 25:557–562

    Article  PubMed  CAS  Google Scholar 

  42. Vrooman OP, Witjes JA (2008) Urinary markers in bladder cancer. Eur Urol 53:909–916

    Article  PubMed  Google Scholar 

  43. Shariat SF, Marberger MJ, Lotan Y et al (2006) Variability in the performance of nuclear matrix protein 22 for the detection of bladder cancer. J Urol 176:919–926; discussion 926

    Article  PubMed  CAS  Google Scholar 

  44. Lotan Y, Shariat SF (2008) Impact of risk factors on the performance of the nuclear matrix protein 22 point-of-care test for bladder cancer detection. BJU Int 101:1362–1367

    Article  PubMed  Google Scholar 

  45. Margulis V, Lotan Y, Shariat SF (2008) Survivin: a promising biomarker for detection and prognosis of bladder cancer. World J Urol 26:59–65

    Article  PubMed  CAS  Google Scholar 

  46. Nicholson JK, Lindon JC, Holmes E (1999) ‘Metabonomics’: understanding the metabolic responses of living systems to pathophysiological stimuli via multivariate statistical analysis of biological NMR spectroscopic data. Xenobiotica 29:1181–1189

    Article  PubMed  CAS  Google Scholar 

  47. Nicholson JK, Connelly J, Lindon JC et al (2002) Metabo-nomics: a platform for studying drug toxicity and gene function. Nat Rev Drug Discov 1:153–161

    Article  PubMed  CAS  Google Scholar 

  48. Rantalainen M, Cloarec O, Beckonert O et al (2006) Statistically integrated metabonomic-proteomic studies on a human prostate cancer xenograft model in mice. J Proteome Res 5:2642–2655

    Article  PubMed  CAS  Google Scholar 

  49. Barton RH, Nicholson JK, Elliott P et al (2008) High-throughput 1H NMR-based metabolic analysis of human serum and urine for large-scale epidemiological studies: validation study. Int J Epidemiol 37(Suppl 1):i31–i40

    Article  PubMed  Google Scholar 

  50. Sievert KD, Amend B, Stenzl A (2007) Tissue engineering for the lower urinary tract: a review of a state of the art approach. Eur Urol 52:1580–1589

    Article  PubMed  Google Scholar 

  51. Becker C, Jakse G (2007) Stem cells for regeneration of uro-logical structures. Eur Urol 51:1217–1228

    Article  PubMed  Google Scholar 

  52. Powles T, Murray I, Brock C et al (2007) Molecular positron emission tomography and PET/CT imaging in urological malignancies. Eur Urol 51:1511–1520; discussion 1520–1521

    Article  PubMed  Google Scholar 

  53. Divgi CR, Pandit-Taskar N, Jungbluth AA et al (2007) Preoperative characterisation of clear-cell renal carcinoma using iodine-124-labelled antibody chimeric G250 (124I-cG250) and PET in patients with renal masses: a phase I trial. Lancet Oncol 8:304–310

    Article  PubMed  CAS  Google Scholar 

  54. Bouchelouche K, Oehr P (2008) Positron emission tomography and positron emission tomography/computerized tomography of urological malignancies: an update review. J Urol 179:34–45

    Article  PubMed  CAS  Google Scholar 

  55. Drieskens O, Oyen R, Van Poppel H et al (2005) FDG-PET for preoperative staging of bladder cancer. Eur J Nucl Med Mol Imaging 32:1412–1417

    Article  PubMed  CAS  Google Scholar 

  56. Even-Sapir E, Metser U, Mishani E et al (2006) The detection of bone metastases in patients with high-risk prostate cancer: 99mTc-MDP Planar bone scintigraphy, singleand multi-field-of-view SPECT, 18F-fluoride PET, and 18F-fluoride PET/CT. J Nucl Med 47:287–297

    PubMed  Google Scholar 

  57. Pichler BJ, Judenhofer MS, Wehrl HF (2008) PET/MRI hybrid imaging: devices and initial results. Eur Radiol 18:1077–1086

    Article  PubMed  Google Scholar 

  58. Sciarra A, Salciccia S, Panebianco V (2008) Proton spectro-scopic and dynamic contrast-enhanced magnetic resonance: a modern approach in prostate cancer imaging. Eur Urol 54:485–488

    Article  PubMed  Google Scholar 

  59. Fuchsjager M, Shukla-Dave A, Akin O et al (2008) Prostate cancer imaging. Acta Radiol 49:107–120

    Article  PubMed  CAS  Google Scholar 

  60. Deserno WM, Harisinghani MG, Taupitz M et al (2004) Urinary bladder cancer: preoperative nodal staging with feru-moxtran-10-enhanced MR imaging. Radiology 233:449–456

    Article  PubMed  Google Scholar 

  61. Guimaraes AR, Tabatabei S, Dahl D et al (2008) Pilot study evaluating use of lymphotrophic nanoparticle-enhanced magnetic resonance imaging for assessing lymph nodes in renal cell cancer. Urology 71:708–712

    Article  PubMed  Google Scholar 

  62. Will O, Purkayastha S, Chan C et al (2006) Diagnostic precision of nanoparticle-enhanced MRI for lymph-node metastases: a meta-analysis. Lancet Oncol 7:52–60

    Article  PubMed  Google Scholar 

  63. Nelson ED, SlotoroffCB, Gomella LG et al (2007) Targeted biopsy of the prostate: the impact of color Doppler imaging and elastography on prostate cancer detection and Gleason score. Urology 70:1136–1140

    Article  PubMed  Google Scholar 

  64. Frauscher F, Klauser A, Volgger H et al (2002) Comparison of contrast enhanced color Doppler targeted biopsy with conventional systematic biopsy: impact on prostate cancer detection. J Urol 167:1648–1652

    Article  PubMed  Google Scholar 

  65. Ismail M, Petersen RO, Alexander AA et al (1997) Color Doppler imaging in predicting the biologic behavior of prostate cancer: correlation with disease-free survival. Urology 50:906–912

    Article  PubMed  CAS  Google Scholar 

  66. Mitterberger M, Pinggera GM, Horninger W et al (2007) Comparison of contrast enhanced color Doppler targeted biopsy to conventional systematic biopsy: impact on Gleason score. J Urol 178:464–468; discussion 468

    Article  PubMed  CAS  Google Scholar 

  67. Mitterberger M, Pinggera GM, Colleselli D et al (2008) Acute pyelonephritis: comparison of diagnosis with computed tomography and contrast-enhanced ultrasonography. BJU Int 101:341–344

    Article  PubMed  Google Scholar 

  68. Frauscher F, Janetschek G, Helweg G et al (1999) Crossing vessels at the ureteropelvic junction: detection with contrast-enhanced color Doppler imaging. Radiology 210:727–731

    PubMed  CAS  Google Scholar 

  69. Pallwein L, Mitterberger M, Aigner F et al (2007) Small renal masses: the value of contrast-enhanced colour Doppler imaging. BJU Int 99:579–585

    Article  PubMed  Google Scholar 

  70. Johnson DB, Duchene DA, Taylor GD et al (2005) Contrast-enhanced ultrasound evaluation of radiofrequency ablation of the kidney: reliable imaging of the thermolesion. J Endourol 19:248–252

    Article  PubMed  Google Scholar 

  71. Kondabolu S, Khan SA, Whyard J et al (2004) The role of endoluminal ultrasonography in urology: current perspectives. Int Braz J Urol 30:96–101

    Article  PubMed  Google Scholar 

  72. Nascimento RG, Coleman J, Solomon SB (2008) Current and future imaging for urologic interventions. Curr Opin Urol 18:116–121

    Article  PubMed  Google Scholar 

  73. Ukimura O, Gill IS (2006) Real-time transrectal ultrasound guidance during nerve sparing laparoscopic radical prostatectomy: pictorial essay. J Urol 175:1311–1319

    Article  PubMed  Google Scholar 

  74. Ukimura O, Magi-Galluzzi C, Gill IS (2006) Real-time transrectal ultrasound guidance during laparoscopic radical prostatectomy: impact on surgical margins. J Urol 175:1304–1310

    Article  PubMed  Google Scholar 

  75. Rosario DJ, Lane JA, Metcalfe C et al (2008) Contribution of a single repeat PSA test to prostate cancer risk assessment: experience from the ProtecT study. EurUrol 53:777–784

    Google Scholar 

  76. Klein EA, Thompson IM, Lippman SM et al (2000) SELECT: the Selenium and Vitamin E Cancer Prevention Trial: rationale and design. Prostate Cancer ProstaticDis 3:145–151

    Article  CAS  Google Scholar 

  77. Thompson IM, Goodman PJ, Tangen CM et al (2003) The influence of finasteride on the development of prostate cancer. N Engl J Med 349:215–224

    Article  PubMed  CAS  Google Scholar 

  78. Thompson IM, Pauler DK, Goodman PJ et al (2004) Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. N Engl J Med 350:2239–2246

    Article  PubMed  CAS  Google Scholar 

  79. Andriole G, Bostwick D, Brawley O et al (2004) Chemo-prevention of prostate cancer in men at high risk: rationale and design of the reduction by dutasteride of prostate cancer events (REDUCE) trial. J Urol 172:1314–1317

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Biosurgery & Surgical Technology, Imperial College London, 10th Floor, QEQM Building, St Mary's Hospital Campus, Praed Street, London, W2 1NY, UK

    Erik Mayer

  2. Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London, W2 1NY, UK

    Justin Vale

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  1. Erik Mayer
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Editors and Affiliations

  1. Dept. Biosurgery & Surgical Technology, Imperial College London St. Mary's Hospital London, 10th floor QEQM Bldg. Praed Street, London, W2 1NY, United Kingdom

    Thanos Athanasiou  & Ara Darzi  & 

  2. UCSF Global Health Sciences, 3333 California Street, Suite 285, San Francisco L, CA, 94143-0443, USA

    Haile Debas

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Mayer, E., Vale, J. (2010). Urology: Current Trends and Recent Innovations. In: Athanasiou, T., Debas, H., Darzi, A. (eds) Key Topics in Surgical Research and Methodology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-71915-1_65

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  • DOI: https://doi.org/10.1007/978-3-540-71915-1_65

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