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Context These guidelines were prepared on behalf of the European Association of Urology (EAU) to assist urologists in the management of traumatic urethral injuries. Objective To determine the optimal evaluation and management of urethral injuries by review of the world's literature on the subject. Evidence acquisition A working group of experts on Urological Trauma was convened to review and summarize the literature concerning the diagnosis and treatment of genitourinary trauma, including urethral trauma. The Urological Trauma guidelines have been based on a review of the literature identified using on-line searches of MEDLINE and other source documents published before 2009. A critical assessment of the findings was made, not involving a formal appraisal of the data. There were few high-powered, randomized, controlled trials in this area and considerable available data was provided by retrospective studies. The Working Group recognizes this limitation. Evidence synthesis The full text of these guidelines is available through the EAU Central Office and the EAU website (www.uroweb.org). This article comprises the abridged version of a section of the Urological Trauma guidelines. Conclusions Updated and critically reviewed Guidelines on Urethral Trauma are presented. The aim of these guidelines is to provide support to the practicing urologist since urethral injuries carry substantial morbidity. The diversity of urethral injuries, associated injuries, the timing and availability of treatment options as well as their relative rarity contribute to the controversies in the management of urethral trauma.

In 2009, two important papers resulting from large, cooperative, randomised, controlled trials [1,2] have appeared addressing the issue of screening for prostate cancer (PCa). Both reports were among the 15 most frequently cited medical papers of 2009. Much of the attention given to the two reports is a result of their apparently contradictory results [3]. The reports have created confusion among medical professionals and among men who consider undergoing screening for PCa. This is in large part due to the difficulty in understanding the contradictory results that are in part based on the different methodologies of both trials. The present editorial is an attempt tometiculously compare the two randomised trials and to provide a simple, understandable view explaining the differences in their outcome. The main sources of information are the two reports on the European Randomized Study of Screening for Prostate Cancer (ERSPC) [1] and the Prostate, Lung, Colorectal and Ovary (PLCO) screening trial [2] and other source documents, such as the supplementary appendices of both papers. Documents reviewing the original protocols, such as the 2003 review of the ERSPC procedures and status [4], and key publications on the design of the PLCO trial [5–7] have been utilized. This editorial addresses only a very limited selection of the extensive, critical secondary literature that has developed after the original publications [1,2]. Comparing the important aspects of the goals, design, methodology, and results of the two large trials should lead to a clear view of the differences in both studies and provide an explanation of the contradictory results: an effect of screening on PCa mortality in the ERSPC trial but not in the PLCO trial.

Context: Most patients with neurogenic lower urinary tract dysfunction (NLUTD) require life-long care to maintain their quality of life (QoL) and to maximise life expectancy. Objective: To provide a summary of the 2008 version of the European Association of Urology (EAU) guidelines on NLUTD and to assess the effectiveness of currently available diagnostic tools, particularly ultrasound imaging and urodynamics. Evidence acquisition: The recommendations provided in the 2008 EAU guidelines on NLUTD are based on a review of the literature, using online searches of Medline and other source documents published between 2004 and 2007. A level of evidence and/or a grade of recommendation have been assigned to the guidelines where possible. Evidence synthesis: NLUTD encompasses a wide spectrum of pathologies, and patients often require life-long, intensive medical care to maximise their life-expectancy and to maintain their QoL. Treatment must be tailored to the needs of the individual patient and, in many cases, involves a multidisciplinary team of experts. Timely diagnosis and treatment are essential if irreversible deterioration of both the upper and lower Urinary tracts are to be avoided. Therapeutic decisions are made on the basis of a comprehensive medical assessment, including urodynamics to identify the type of dysfunction. Advances in investigative technologies have facilitated the noninvasive and conservative management of patients who have NLUTD. Conclusions: The diagnosis and treatment of NLUTD, which is a highly specialised and complex field involving both urology and medicine, requires up-to-date expert advice to be readily available. The current guidelines are designed to fulfil this need. (C) 2009 European Association of Urology. Published by Elsevier B.V. All rights reserved.