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

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.

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

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.

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

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

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.

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

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

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.

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.

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.

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