In this Perspective, Larcher et al. describe a dedicated treatment programme for Von Hippel–Lindau disease established at San Raffaele Hospital, which encompasses diagnosis, surveillance, treatment, research and outreach. The authors then discuss the benefits of care centralization for Von Hippel–Lindau disease and other rare diseases.

A subset of men with prostate cancer have elevated periprostatic androgens compared with levels in peripheral blood, which are associated with poor clinical outcomes after radical prostatectomy. This new paradigm for gonadal androgen physiology is termed ‘sneaky T’ phenomenon.

Antibiotic-resistant uropathogenic bacteria are becoming increasingly prevalent. In this Review, strategies for clinicians and researchers to address this challenge are delineated, including implementation of policies, stewardship practices, and the exploration of emerging therapeutic targets aimed at mitigating antibiotic resistance.

Urothelial cancer is the tenth most diagnosed cancer worldwide, and between 5% and 10% of patients have metastatic disease at diagnosis. Furthermore, up to 50% of patients are ineligible for cisplatin, the first-line treatment option, and require alternative options. In this comprehensive Review, the authors discuss the current and future therapeutic options for advanced urothelial cancer, including chemotherapeutics, targeted therapies and antibody–drug conjugates, and consider how these agents might change patient management.