A new phase III, randomized, controlled trial was carried out to assess the efficacy of 177Lu-PSMA-617 in patients with taxane-naive metastatic castration-resistant prostate cancer (mCRPC). A total of 468 patients with PSMA+ mCRPC who experienced disease progression after receiving an androgen receptor pathway inhibitor (ARPI) were randomly allocated to receive 177Lu-PSMA-617 or a different ARPI. Treatment

The multicentre, randomized, phase III trial TiNivo-2 was conducted to assess the efficacy of the vascular endothelial growth factor receptor inhibitor tivozanib alone versus in combination with the immune checkpoint inhibitor (ICI) nivolumab in patients with advanced renal cell carcinoma (RCC) who had progressed during or after 1–2 previous lines of therapy including one ICI. Progression-free survival

From 23 to 25 October 2024, Madrid hosted the 54th edition of the annual meeting of the International Continence Society (ICS), the leading multi-disciplinary event in the continence field, bringing together healthcare professionals in the fields of urology, gynaecology, physiotherapy and nursing with the common interest of treating incontinence. The future of continence was the central theme of the

Literature about prostate cancer in transgender women is growing, but many questions remain unanswered. Unique challenges exist in the identification of transgender women that can slow or even impair research advances in this field. Reframing our thinking about the identification of this population is imperative to help advance both research and clinical care.

When Nature Clinical Practice Urology launched in 2004, we could not have foreseen the ways in which our field has transformed. As we celebrate our 20th anniversary — traditionally, the ‘china’ anniversary — it gives us a chance to get out the special china tea service, sit back with a cup of tea and reflect on what this journal, and the editors who work on it, have achieved.

In the USA, Black men are approximately twice as likely to be diagnosed with and to die of prostate cancer than white men. In the UK, despite Black men having vastly different ancestral contexts and health-care systems from Black men in the USA, the lifetime risk of being diagnosed with prostate cancer is two-to-three times higher among Black British men than among white British men and Black British

Disulfidptosis is a programmed cell death pathway in prostate cancer. A study in Scientific Reports has investigated the roles of genes related to disulfidptosis in disease pathogenesis and progression. The team developed a risk scoring model and then examined the relationship between this score and immune characteristics, somatic mutations and responses to therapy. Two disulfidptosis subtypes were

A study in Scientific Reports has used isotransplantation to examine the effect of mouse breeding nuclei in prostate cancer development and intratumoural macrophage populations, illustrating the importance of understanding mouse models to explore the tumour immune microenviroment (TIME). TRAMP-C1 cells were implanted into C57BL/6J mice from two breeding nuclei (nA and nB) and tumour growth period and

For the past 20 years, Nature Reviews Urology has evolved alongside the field, reflecting a shift towards basic research as a tool to inform clinical practice. From the latest developments in urology to the advent of telehealth, the journal has remained committed to delivering rigorous and unbiased science, accessible to a global audience.

Over the past 20 years, Nature Reviews Urology has been at the forefront of developments in the field — from championing men’s health to explaining the intricacies of the prostate cancer tumour immune microenvironment. Going forwards the journal will continue to be a leader in the field, providing an important resource for patients and physicians alike.

Intermediate-risk and high-risk localized prostate cancer are treatable, but metastases (in ~30% of patients) often lead to death. Immunotherapy shows promise for survival, but many patients do not respond, highlighting the need for biomarkers to predict metastases and treatment response. In an article published in Scientific Reports, a novel indicator based on cell death was developed to predict metastases

Proof of concept has been demonstrated for a modern and safe immuno-nanotherapy for prostate cancer in a study published in Experimental & Molecular Medicine. These results provide the possibility of a novel, effective treatment strategy for prostate cancer. Using a microfluidic device, the investigators designed and synthesized a nonimmunogenic biocompatible cationic lipid nanocomplex coated with

Women are under-represented in surgery and are particularly subject to the intrinsically gendered practice of pimping in the clinical learning environment. The potential downstream effects of this continued practice have considerable implications on gender disparities within surgical disciplines.

The incidence of detrusor underactivity is projected to rise owing to an ageing population and the increasing prevalence of diabetes, but therapeutic options remain limited. Successful bladder contractions have been yielded in studies of bladder pacing in animals. However, anatomical incongruities highlight the need for human trials. Bladder pacing in humans through electrical stimulation has shown

New research, published in Nature, shows that gut microbiota carcinogen metabolism could contribute to chemical-induced carcinogenesis in the bladder. Chronic exposure to N-butyl-N-(4-hydroxybutyl)-nitrosamine (BBN) induces bladder cancer in mouse models. Thus, the investigators used this model to examine the influence of gut microbiota on BBN-induced carcinogenesis and toxicokinetics.

In a new study published in JAMA Internal Medicine, the association between patients abandoning or reversing the pre-exposure prophylaxis (PrEP) prescription and the specialty of the prescribing clinician has been assessed. Overall, 37,003 patients who were prescribed PrEP were assessed using pharmacy claims data. The majority of patients (67%) received their prescription from primary care practitioners

Intra-tumour heterogeneity in patients with metastatic castration-resistant prostate cancer (mCRPC) poses a challenge to treatment, owing to variability in tumour growth and response to therapy. Currently available tools such as response evaluation criteria in solid tumors (RECIST) and circulating tumour DNA (ctDNA) are useful methods to measure patient response to treatment but do not enable the assessment

PIWI-interacting RNAs (piRNAs) are crucial regulators of gene expression in male germ cells. In a study published in Nature Communications, the effect of disrupting piRNA biogenesis on human spermatogenesis was assessed. Analysis of exome data from >2,000 men with infertility led to the identification of biallelic variants in 14 genes related to the piRNA pathway in these men. These variants were associated

Measuring bladder volume is essential to assess bladder function for diagnosis and monitoring of lower urinary tract dysfunction, but currently available methods such as catheterization or ultrasonography are invasive and limited to the hospital setting. In a new study published in Nature Communications, a wireless and flexible ultrasonic bladder volume monitoring (UBVM) device was developed for continuous

Artificial intelligence can be leveraged to improve the detection of prostate cancer on magnetic resonance imaging; however, before this technology is implemented in clinical practice, further research is required.

Artificial intelligence (AI) is transforming prostate cancer management from diagnosis to treatment. AI tools have been designed for the analysis of digitized histopathology and MRI scans, generation of synthetic CT scans and improvement of robotic surgical outcomes. This progress underscores the need for regulation and the development of safe, ethical and non-biased software.

Currently, no consensus biomarker exists for predicting priapism associated with sickle cell disease. Biochemical and haematological parameters have been investigated, but they are limited by a lack of specificity and the need for pre-validated thresholds. Genetic biomarkers are a potential alternative for further consideration in future efforts.

The idea that common epithelial cancers evolve from dysplasia or carcinoma in situ has been challenged by the discovery of occult disease in normal-appearing cells, known as the field effect, which interests areas that might form large plaques in the mucosal membrane. Forerunner (FR) genes, which map to genomic regions close to established tumour-suppressor genes, seem to have a role in this process

Transgender women are more likely to be diagnosed with high-grade prostate cancer than cisgender men, which might be ascribed to a delayed diagnosis. In a study published in JAMA, the authors assessed prostate-specific antigen (PSA) values in a cohort of transgender women receiving oestrogen treatment, prompted by the rationale that the levels of PSA (which are regulated by androgen) might be altered

Single-cell analysis of treatment-resistant prostate cancer demonstrated high heterogeneity between cell states across various advanced disease types, including castration-resistant and neuroendocrine prostate cancers. Expression of PSMA, STEAP1, STEAP2, TROP2, CEACAM5 and DLL3 were observed to vary within a subset of gene regulatory networks. Thus, gene regulatory networks could be used to identify

Virtual screening using Rosetta software and an online server was employed to design a proteolysis-targeting chimera drug targeting p300 for prostate cancer therapy. Rosetta calculated the overall interface binding score and fold stability score. The amino acid with the highest frequency at each interface site was selected for generating the final peptide sequence, which was CPWIWDGDNKDDNSTDGGGSGGGTSFEQFWAWLWP

A cradle-to-grave life-cycle assessment has been undertaken of the greenhouse gas emissions from the transurethral resection of bladder tumour (TURBT) pathway. The median carbon footprint of perioperative TURBT was 131.8 kg of CO2 equivalent. Multiple modifiable hotspots were found, including minimizing avoidable patient travel, rationalizing equipment use, optimally filling operating theatre lists

Single-agent retifanlimab has shown promising signs of clinical activity in advanced and metastatic penile squamous cell carcinoma with no new safety signals. Objective response rate was 16.7% and three patients had a partial response. Median progression-free survival was 2.0 months and median overall survival was 7.2 months. One patient experienced a grade 3 treatment-related adverse event. The results

Accurate information concerning urological issues can be obtained from artificial intelligence chatbots, according to the results of two recent studies. However, understandability and actionability could be improved. ChatGPT4.0 showed utility in aiding clinical decision-making regarding male infertility. The performance of ChatGPT4.0 in answering 1,073 true or false, multiple-choice and open-ended

Syphilis, caused by the bacterium Treponema pallidum subsp. pallidum (TPA), re-emerged as a global health problem in the twenty-first century, with a drastic increase in syphilis diagnoses reported in the past 20 years. Injection with the long-acting benzathine penicillin G is the gold-standard treatment for syphilis, but the increased number of patients combined with a limited supply chain capacity

First described in the 1850s by Wilhelm Krause, the function and physiological functions of the sensory structures that bear his name have remained unclear. However, a study in Nature has shown that Krause corpuscles have an important role in genital sensation. The team from Harvard University began by assessing the distribution and density of Krause corpuscles. In the genitalia of female mice, corpuscles

Survival of xenograft kidneys in allosensitized recipients is extended when using kidneys from pigs with multiple genetic changes. This observation suggests that highly allosensitized patients could obtain great benefit from clinical implementation of xenotransplantation. In this preclinical, non-human primate study, rhesus macaques were first highly allosensitized. Next, five of these macaques received

Use of alternative promoters by oncogene transcription factors increases as prostate tumours progress from benign to metastatic castration-resistant disease. This observation indicates that alternative promoter use intensifies the transcriptional effects of tumour-driving genes in prostate cancer. Deep RNA-sequencing analysis of 274 biopsy samples of benign prostate tissue, localized prostate tumours

The presence of microplastics has been found in human penile tissue. This discovery has implications for male fertility and our understanding of the effects of environmental pollutants on reproductive health. This study involved six participants who were undergoing surgery for a multi-component inflatable penile prosthesis. A stringent protocol for sample collection from the corpora was implemented

Partial nephrectomy aims to provide both effective oncological management and renal function preservation. Surgical complications pertaining to the defect created during a partial nephrectomy include haemorrhage and urinary leak. We explore advances in techniques for managing the defect created during a partial nephrectomy (renorrhaphy).

BCG treatment is the gold-standard therapy for high-grade intermediate-risk and high-risk non-muscle-invasive bladder cancer (NMIBC). However, ~30−40% of patients who receive BCG experience treatment failure, and the mechanisms by which it acts are not well understood. Thus, the role of the tumour microbiome in bladder cancer treatment response has gained increasing interest. Now, new data have provided