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Syphilis on the rise — a need for alternative therapies and vaccines Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-16 Maria Chiara Masone
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
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Krause corpuscles act as genital vibration detectors Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-16 Annette Fenner
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
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Increased xenokidney survival Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-15 Louise Lloyd
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
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Alternative promoters activate oncogenic programmes Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-12 Louise Lloyd
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
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Microplastics in the penis Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-12 Louise Lloyd
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
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Optimizing cystoscopy and TURBT: enhanced imaging and artificial intelligence Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-09 Eugene Shkolyar, Steve R. Zhou, Camella J. Carlson, Shuang Chang, Mark A. Laurie, Lei Xing, Audrey K. Bowden, Joseph C. Liao
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Biological determinants of PSMA expression, regulation and heterogeneity in prostate cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-08 Martin K. Bakht, Himisha Beltran
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CRISPR–Cas9 potential for identifying novel therapeutic targets in muscle-invasive bladder cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-07-01 Danielle J. Smith, Sapna Lunj, Antony D. Adamson, Sankari Nagarajan, Tim A. D. Smith, Kimberley J. Reeves, Peter J. Hoskin, Ananya Choudhury
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De-clear cell differentiated renal cell carcinoma — a new therapeutic target Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-27 Keith A. Lawson, W. Marston Linehan
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Advances in sliding clip renorrhaphy for partial nephrectomy Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-25 David Homewood, Tayla Fay, Nicholas Tan, Andrew Silagy, Niall M. Corcoran, Nathan Lawrentschuk, Dinesh Argarwal
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).
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Renal mass biopsy — a practical and clinicopathologically relevant approach to diagnosis Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-21 Hussein Mansour, My-Anh Tran-Dang, Miles Walkden, Ekaterini Boleti, Ravi Barod, Prasad Patki, Faiz Mumtaz, Maxine G. B. Tran, Axel Bex, Soha El Sheikh
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The bladder tumour microbiome and BCG response Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-18 Louise Lloyd
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
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Progression-free survival end points in prostate cancer: are we truly making progress Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-17 Ravi A. Madan, Edwin M. Posadas, Richard J. Lee
Recently, several therapeutic strategies in prostate cancer have been granted regulatory approval based on progression-free survival benefits alone, which is a relative change in the therapeutic development of prostate cancer treatments. Previously, overall survival was a requirement for approvals. Whether this approach is warranted or beneficial to patients remains unclear.
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Single-cell penile cancer atlas to identify disease drivers Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-14 Maria Chiara Masone
Penile squamous cell carcinoma (PSCC) can be classified into human papilloma virus-positive (HPV+) and HPV-independent (HPV–). HPV+ tumours have higher rates of poorly differentiated disease than HPV– tumours. However, a lower cancer-specific mortality (CSM) has been reported in patients with HPV+ versus HPV– disease. This evidence might be partially explained by a disproportionate occurrence of loss-of-function
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Promising efficacy of UTI vaccines as an alternative to antibiotics Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-14 Quentin Mak, Julian Greig, Prokar Dasgupta, Sachin Malde, Nicholas Raison
Antibiotics are the mainstay prophylaxis and treatment for recurrent urinary tract infections (UTIs). However, antibiotic resistance is rising globally, leading to infections that are harder to treat. In view of this resistance, alternative, non-antibiotic treatments for recurrent UTIs are now being developed; among them, UTI vaccines have shown promising results.
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A prompt-based stewardship to reduce extended-spectrum antibiotic treatment in UTI Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-13 Maria Chiara Masone
Hospitalized patients with urinary tract infection (UTI) often receive treatment with extended-spectrum antibiotics while waiting for culture results, as a precaution in case of multidrug-resistant organism (MDRO) infections. However, most of these patients could be treated with standard-spectrum antibiotics. In the cluster-randomized INSPIRE trial, the effect of the new INSPIRE antibiotic stewardship
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A new signalling-based system for germ cell reprogramming Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-13 Maria Chiara Masone
Differentiation of human primordial germ cells (hPGCs) to mitotic spermatogonia and oogonia occurring through epigenetic reprogramming is a fundamental process of development. hPGC-like cells (hPGCLCs) have been successfully induced in vitro starting from human pluripotent stem cells (hPSCs) but have low efficiency and are prone to de-differentiation. In a paper published in Nature, the authors established
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Engaging medical students in urological academic research Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-06-11 Kamil Malshy, Taylor Braunagel, Anna Ochsner, Borivoj Golijanin, Elias Hyams
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Rediscovering citrate as a biomarker for prostate cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-29 Lucas Galey, Ayokunle Olanrewaju, Hermann Nabi, Jean-Sébastien Paquette, Frédéric Pouliot, Étienne Audet-Walsh
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Nocturia and obstructive sleep apnoea Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-23 Olaf P. J. Vrooman, Philip E. V. van Kerrebroeck, Michael R. van Balken, Gommert A. van Koeveringe, Mohammad S. Rahnama’i
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Preclinical models of bladder cancer: BBN and beyond Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-20 David Matye, Juliann Leak, Benjamin L. Woolbright, John A. Taylor
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Overall survival with adjuvant pembrolizumab in renal cell carcinoma — the shock of the lightning Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-17 Francesco Massari, Matteo Rosellini, Veronica Mollica
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Promoting the health of men of all backgrounds: educating ourselves to build trust and improve care Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-16 Danly Omil-Lima, Austin Thompson, Kyle Scarberry, Benjamin Crawshaw
Specific issues affect the treatment of urological cancer and survivorship in gay and bisexual men. Creating an accepting and inclusive environment for these patients in our men’s health clinics can help to improve the quality of life for men from sexual minority groups undergoing cancer treatment.
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AUA24 — pioneering shared decision-making and patient engagement strategies Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-15 Maria Chiara Masone
Urologists, scientists and other professionals in the urology field converged in San Antonio, Texas, to attend the 119th edition of the American Urological Association (AUA) Annual Meeting. An intense and variegated programme was put together to cover the latest advances in different areas of urology, with an eye to the future of the field. Providing an equitable health care for Black men, who experience
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Chromosome segregation in SCNT oocytes Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-14 Louise Lloyd
The possibility of men in same-sex relationships and people who do not have their own eggs having biological children has been advanced by new research into in vitro gametogenesis, in which functional haploid gametes are generated from diploid somatic cells. In previous, proof-of-principle experiments showing that haploidy in somatic cell genomes can be induced experimentally by premature cell division
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Overcoming barriers in cancer care for gender minorities Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-13 David J. Benjamin, Omid Yazdanpanah, Arash Rezazadeh Kalebasty
As the population of gender minorities grows in the setting of rising incidence of cancers globally, health-care professionals and institutions must be prepared to provide inclusive care. Individual-level training as well as institutional-level efforts on gender identity data collection and creation of inclusive clinical spaces could help mitigate health-care disparities.
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We all get erections — de-gendering sexual arousal dysfunction in the ICD Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-08 Lucy Greenwald, Daniel R. Dickstein, Barbara Chubak, Deborah C. Marshall
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Breaking the silence: normalizing receptive anal intercourse for patients, for people and for myself Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-08 Daniel R. Dickstein
The lack of information and discussion on receptive anal intercourse (RAI) perpetuates the stigma. Normalizing RAI and empowering individuals to embrace their sexuality without shame or judgement requires us to confront biases, foster dialogue and break the silence.
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Centralization of care for rare genetic syndromes associated with cancer: improving outcomes and advancing research on VHL disease Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-08 Alessandro Larcher, Federico Belladelli, Francesco Cei, Chiara Re, Isaline Rowe, Francesco Montorsi, Umberto Capitanio, Andrea Salonia
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Asexuality: the invisible orientation Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-07 Sarah Cosgriff, Stella Schneckenburger
Asexuality is often neglected in education and conversations around sexuality, making it essentially an ‘invisible orientation’. This lack of knowledge is associated with harmful misconceptions, which need challenging within the medical profession and in the general population to ensure inclusion of people who identify on the asexual spectrum.
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Elevated periprostatic androgens, sneaky testosterone and its implications Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-07 Masoud Bitaraf, Ranjith Ramasamy, Sanoj Punnen, Nima Sharifi
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Current and emerging strategies to curb antibiotic-resistant urinary tract infections Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-07 Aaron Simoni, Laura Schwartz, Guillermo Yepes Junquera, Christina B. Ching, John David Spencer
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The evolving treatment landscape of metastatic urothelial cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-03 Giandomenico Roviello, Matteo Santoni, Guru P. Sonpavde, Martina Catalano
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Von Hippel–Lindau protein signalling in clear cell renal cell carcinoma Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-02 Chengheng Liao, Lianxin Hu, Qing Zhang
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Strengthening preclinical testing to increase safety in surgical mesh Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-05-01 Nicholas T. H. Farr, Victoria L. Workman, Christopher R. Chapple, Sheila MacNeil, Cornelia Rodenburg
Inflammatory and fibrotic responses to polypropylene mesh led to the withdrawal of this practice for treatment of stress urinary incontinence and pelvic organ prolapse in women in some countries. Improved material testing has been urged. We report poor responses of polypropylene mesh to repeated mechanical distension and macrophage interrogation. These results from preclinical in vitro testing show
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From biology to the clinic — exploring liver metastasis in prostate cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-26 Xudong Ni, Yu Wei, Xiaomeng Li, Jian Pan, Bangwei Fang, Tingwei Zhang, Ying Lu, Dingwei Ye, Yao Zhu
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Influence of substance use on male reproductive health and offspring outcomes Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-25 Jamie O. Lo, Jason C. Hedges, Wesley H. Chou, Kylie R. Tager, Ian D. Bachli, Olivia L. Hagen, Susan K. Murphy, Carol B. Hanna, Charles A. Easley
The prevalence of substance use globally is rising and is highest among men of reproductive age. In Africa, and South and Central America, cannabis use disorder is most prevalent and in Eastern and South-Eastern Europe, Central America, Canada and the USA, opioid use disorder predominates. Substance use might be contributing to the ongoing global decline in male fertility, and emerging evidence has
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Bladder cancer variants — one disease with many faces Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-22 Bogdan Czerniak
Bladder cancer progression to microscopically distinct variants such as sarcomatoid, small cell, micropapillary and plasmacytoid is associated with more aggressive clinical behaviour than conventional carcinoma. Advances in molecular profiling led to the identification of molecular subtypes of bladder cancer and provided insights into disease progression to aggressive variants.
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EAU à la mode Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-17 Louise Lloyd
Urologists from around the world congregated at the 39th Annual Congress of the European Association of Urology (EAU), which took place in Paris, France, between 5 and 8 April 2024. In the Olympic host city, the Olympian efforts of clinicians and researchers in the field to improve knowledge and understanding and, ultimately, patient outcomes were evident around the convention centre. Day 1 of the
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The evolving landscape of monogenic nephrolithiasis and therapeutic innovations Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-17 Chen-Han Wilfred Wu, Yu-Ren Huang, Donald Bodner, Fredrick R. Schumacher, Michelle Baum, Friedhelm Hildebrandt
Monogenic causes account for up to 20% of nephrolithiasis instances and are crucial for developing targeted treatments. Whole-exome sequencing, genome-wide association, candidate gene, and in vitro and animal functional studies are crucial to identify these mutations. Therapies targeting monogenic variants, such as RNA-interference-based treatments, have been successfully used to treat monogenic disorders
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Patient-reported toxic effects of hypofractionated versus conventional RT Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-16 Maria Chiara Masone
Post-prostatectomy radiotherapy (RT) is a common second-line treatment for patients with prostate cancer. In the phase III randomized NRG-GU003 trial, hypofractionated postprostatectomy RT (HYPORT) was compared with conventionally fractionated postprostatectomy RT (COPORT) in terms of patient-reported genitourinary (GU) and gastrointestinal (GI) symptoms in patients with prostate cancer who had received
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Safe delivery of ICI therapy through sub-urothelial injection Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-16 Maria Chiara Masone
Systemic treatment with the human monoclonal anti-PDL1 antibody durvalumab showed benefit in several cancers. In a phase Ib study published in BJU International, the safety of sub-urothelial durvalumab injection was assessed in patients with non-metastatic muscle-invasive or non-muscle-invasive bladder cancer planned to receive radical cystectomy. Overall, 11 patients received sub-urothelial injection
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HRQoL in patients receiving EV versus chemotherapy Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-16 Maria Chiara Masone
In the phase III EV-301 trial, enfortumab vedotin (EV) has been shown to increase overall survival compared with chemotherapy in patients with metastatic urothelial carcinoma who had previously received chemotherapy and experienced disease progression after treatment with PD1 or PDL1 inhibitors. In a study published in European Urology, patient-reported outcome (PRO) analysis of health-related quality
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Unlocking ferroptosis in prostate cancer — the road to novel therapies and imaging markers Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-16 Pham Hong Anh Cao, Abishai Dominic, Fabiola Ester Lujan, Sanjanaa Senthilkumar, Pratip K. Bhattacharya, Daniel E. Frigo, Elavarasan Subramani
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A CAF subpopulation promotes LVI in early-stage bladder cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-15 Maria Chiara Masone
In a new article published in Cancer Cell, a subset of cancer-associated fibroblasts (CAFs) was shown to have a crucial role in promoting lymphovascular invasion (LVI) in early-stage bladder cancer. In this study, LVI analysis in tissue samples from patients with bladder cancer showed that LVI in patients with early-stage disease was associated with increased rates of lymph node (LN) metastases and
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The case for centralization of care in penile cancer — respecting geographical needs Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-04-15 Giuseppe Basile, Andrea Necchi, Gagan Prakash, Karima Oualla, Philippe E. Spiess, Peter A. S. Johnstone
Centralization of care for penile cancer has been underscored in the 2023 updated EAU–ASCO guidelines. Expertise consolidation enhances patient care, addressing penile cancer complexities from diagnosis to treatment. Centralization initiatives, like the European Reference Networks, and dedicated scientific societies have crucial roles in guiding centralized care pathways to ultimately improve patient
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Signatures of metabolic diseases on spermatogenesis and testicular metabolism Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-03-25 David F. Carrageta, Sara C. Pereira, Rita Ferreira, Mariana P. Monteiro, Pedro F. Oliveira, Marco G. Alves
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Robots learning to imitate surgeons — challenges and possibilities Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-03-21 Samuel Schmidgall, Ji Woong Kim, Axel Krieger
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Overcoming antibiotic resistance in complicated UTI Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-03-14 Maria Chiara Masone
Complicated urinary tract infection (UTI) is a debilitating condition often resulting in patient hospitalization and consequent high health-care costs. β-lactam antibiotics such as cephalosporins are often used to treat complicated UTI, but a widespread resistance to antibiotics hampers the eradication of these infections. The phase III, randomized, double-blind, double-dummy trial CERTAIN-1 was conducted
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The ins and outs of penile erection Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-03-14 Louise Lloyd
New discoveries concerning the function of fibroblasts in penile erection have improved our understanding of this physiological process. In humans, fibroblasts are the largest cell population in the corpora cavernosa, but until now their function had not been elucidated. “We study perivascular fibroblasts in the context of fibrosis in the central nervous system and I was curious about their physiological
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Robotic kidney transplantation Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-03-13 Giuseppe Basile, Alessio Pecoraro, Andrea Gallioli, Angelo Territo, Camille Berquin, Jorge Robalino, Alejandra Bravo, Jorge Huguet, Óscar Rodriguez-Faba, Pavel Gavrilov, Carmen Facundo, Lluis Guirado, Josep Maria Gaya, Joan Palou, Alberto Breda
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Diversifying editorial boards to mitigate the global burden of genitourinary cancers Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-03-01 David J. Benjamin, Zhaohui Arter, Nataliya Mar, Arash Rezazadeh Kalebasty
The growing global burden of genitourinary cancers is disproportionately shouldered by low- and middle-income countries. Medical journals offer an avenue for discourse among different stakeholders to strategize and identify solutions. Thus, achieving diversity in this context is crucial to put together a heterogeneous group of stakeholders with diverse personal and cultural experiences as well as distinct
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Targeting histone modifiers in bladder cancer therapy — preclinical and clinical evidence Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-19 Shiyu Zhang, Tianhai Lin, Xingyu Xiong, Chong Chen, Ping Tan, Qiang Wei
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The evolving management of small renal masses Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-16 Yuzhi Wang, Mohit Butaney, Samantha Wilder, Khurshid Ghani, Craig G. Rogers, Brian R. Lane
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Sun, sea, sex and spaghetti as the ESSM hits Bari Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-16 Annette Fenner
Delegates were treated to a fantastic menu of both science and gastronomy as the European Society for Sexual Medicine (ESSM) Congress met in Bari, southern Italy, 9–11 February 2024. Unsurprisingly, Italy topped the list of attendees at this cosmopolitan meeting, which saw 650 delegates converge from across the world to discuss the latest research and topics in sexual medicine. A total of 72 scientific
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ADT intensification to treat biochemically recurrent prostate cancer Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-14 Maria Chiara Masone
In the randomized phase III, open-label trial PRESTO, the effect of potentiating androgen deprivation therapy (ADT) on improving oncological outcomes in patients with biochemically recurrent prostate cancer (BRPC) was assessed. Patients with BRPC (n = 503) and a short PSA doubling time (≤9 months) were enrolled and randomized 1:1:1 to receive ADT (control arm), ADT + apalutamide, or ADT + apalutamide + abiraterone
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A new rapid point-of-care test for N. gonorrhoeae Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-14 Maria Chiara Masone
The lack of a rapid, cheap point-of-care test to diagnose infection with Neisseria gonorrhoeae has led to overuse of antibiotics and syndromic treatment. In a study published in The Lancet, the diagnostic performance of a new N. gonorrhoeae lateral flow assay (NG-LFA), which had shown promising results in frozen clinical specimens, was assessed in male patients with urethral discharges (n = 200) and
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Mellow yellow: BilR reduces bilirubin to urobilinogen Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-14 Louise Lloyd
Researchers have identified the enzyme, now called bilirubin reductase (BilR), that converts bilirubin to urobilinogen, giving urine its distinctive yellow colour. The reduction of bilirubin to urobilinogen is performed solely by the gut microbiota; however, hitherto the gut microbial enzyme that reduces bilirubin to urobilinogen had not been discovered. Using a fluorescence assay on various bacteria
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First-morning urine samples to study the urobiome Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-14 Maria Chiara Masone
The urinary microbiome (urobiome) is emerging as a new contributing factor in determining bladder cancer risk, but data from different studies are conflicting, owing to the lack of standardization. In a new study published in European Urology Open Science, a urobiome analysis was conducted in 48 patients undergoing transurethral resection of bladder tumour, through the next-generation sequencing analysis
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RNA N6-methyladenosine modifications in urological cancers: from mechanism to application Nat. Rev. Urol. (IF 12.1) Pub Date : 2024-02-12 Lei Yang, Jianming Ying, Qian Tao, Qian Zhang