Reviews & Analysis

This Review discusses the mechanisms and origins of cardiovascular risks associated with prostate cancer therapies, mainly focusing on differences between gonadotropin-releasing hormone agonists and antagonists. Cardiovascular risks associated with all other available prostate cancer treatments are also discussed.

The results of the NIAGARA trial have considerably advanced treatment for patients with muscle-invasive bladder cancer, establishing a new therapeutic standard for cisplatin-eligible patients. Future trials will help to answer remaining questions about perioperative treatment optimization.

Bladder instillation of gentamicin is safe and effective in treating recurrent urinary tract infection that has failed to resolve with current guideline-based treatments. It also reduces the rate of antimicrobial resistance.

In this Review, the authors describe the intricate interplay of chemo-radio-immuno-sensitization in advanced penile squamous cell carcinoma with human papillomavirus (HPV) co-infections. By drawing parallels with other HPV-driven tumours, they provide arguments for the development of effective therapeutic strategies tailored to the unique characteristics of advanced penile squamous cell carcinoma with HPV co-infection.

In this Review, the authors provide a comprehensive historical overview of the advancements in the understanding of biology and genetics of paediatric renal non-Wilms tumours, and discuss how this information can be used to develop new targeted therapies for these rare cancers.

Anterior prostate cancers, a group of impalpable neoplasms located in regions anterior to the urethra, are typically undersampled using conventional biopsy schemes, leading to a low detection rate and a high rate of false negatives. In this Review, the authors discuss the optimal diagnostic approaches to anterior prostate cancers and consider management and outcomes for patients with this form of prostate cancer.

Here, the authors describe the links between planetary health, climate change and urological disease, as well as some of the challenges and potential strategies for urological care providers in the era of anthropogenic climate change.

In this Review, the authors present an overview of epigenetic alterations implicated in prostate cancer pathophysiology, focusing on epigenetic diagnostic and prognostic biomarkers. Development and potential for future clinical implementation of epidrugs targeting epigenetic modifications for prostate cancer treatment are also discussed.

This Review evaluates the contemporary evidence on the physiology of pain after percutaneous nephrolithotomy and provides evidence-based recommendations to optimize pain control and patient experience, including surgical, pharmacological and psychosocial considerations.

In this Review, the authors summarize the most important findings made using spatial transcriptomics in clear-cell renal cell carcinoma samples from patients.

In this Review, the functional and molecular consequences of pathological hypoxia on male germ cells and fertility are explored, including potential influences on embryo development and transgenerational effects on offspring health.

Prolonged antibiotic treatment is often used clinically for patients with overactive bladder; however, this approach is contrary to existing recommendations regarding the prolonged non-specific use of antibiotics. In this Perspective, the authors consider the evidence — or lack thereof — for this approach and discuss how patients with overactive bladder should be managed.

Neuromodulation has been used in the treatment of overactive bladder for almost 40 years. Several studies have confirmed its clinical effect. In this Review, existing evidence related to the mechanism of action of neuromodulation is synthesized.

In some instances (<5%), non-muscle-invasive bladder cancer can progress to metastatic disease without any signs of bladder muscle or lympho-vascular invasion, a condition known as metastatic non-muscle-invasive bladder cancer. In this Perspective, the authors present the available literature on metastatic non-muscle-invasive bladder cancer, and discuss the potential aetiologies underlying this condition.

The circadian rhythm has a crucial role in regulating nocturia. In this Review, the authors discuss how the brain–kidney–bladder circadian axis can lead to nocturia, prompted by the rationale that understanding these disruptions can lead to developing effective treatments targeting circadian rhythms.

In this Review, the authors provide an overview of molecular imaging in renal cell carcinoma, discussing the role of molecular imaging approaches in renal cell carcinoma diagnosis, treatment and response monitoring.

A common germline missense-encoding polymorphism in HSD3B1, called the adrenal-permissive allele, facilitates androgen synthesis from adrenal precursors via increased 3β-hydroxysteroid dehydrogenase 1 (3βHSD1). Here, the authors focus on mechanistic and clinical investigations of 3βHSD1 and the clinical consequences and potential utility of detecting adrenal-permissive allele inheritance.

High-fat diets disrupt testicular function by accumulating lipids, impairing sperm production and affecting the cytoskeleton of spermatogenic cells. This Perspective aims to understand these mechanisms to develop treatments for infertility in men with obesity.

Metastatic urothelial cancer exhibits substantial molecular heterogeneity compared with the primary tumour, complicating the development of accurate biomarkers. Pre-treatment metastatic biopsies capture real-time tumour biology and can enhance response predictions for targeted therapies, improving patient selection for precision oncology.

Examination of racial disparities in prostate cancer in the USA and UK highlights systemic, socio-economic and sociocultural factors that might contribute to these differences. Understanding behavioural medicine might inform and improve the way in which the health-care system can engage with patients in minorities who are affected by this disease.