Reviews & Analysis

Chromosomal instability is a hallmark of advanced prostate cancer. In this Review, the authors discuss the biological causes and paradoxical consequences of chromosomal instability, its potential clinical role in the stratification of prostate cancer aggressiveness and the development of novel treatment strategies.

African American men are disproportionately affected by prostate cancer in the USA. In this Review, the authors discuss the complex interplay of modifiable risk factors that might underlie the glaring prostate cancer disparities observed.

Muscle-invasive bladder cancer with clinically positive pelvic lymph nodes is a particular situation at the interface between localized and metastatic disease. In this Review, the authors discuss the advances and challenges of currently available strategies for the diagnosis and treatment of patients with muscle-invasive bladder cancer with clinically positive pelvic lymph nodes.

Antiretroviral therapy means that people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. In this Review, the authors discuss the risk of genitourinary cancers in PLWH, the inequity of health care access and consider how including PLWH in ongoing cancer trials can help to improve cancer care for this population.

The use of English language as the official language in science had an undoubtable role in moving science forward but posed an extra challenge for people whose first language is not English. In this Viewpoint, six non-Native English speakers share their experience as academics, clinicians, researchers and editors who carry out the core tasks of their jobs in a second language, and suggest potential solutions to help overcome issues associated with a linguistic barrier. Their stories show the substantial challenges that non-native English speakers have to face every day regardless of their career status, but also highlight the opportunities that this form of diversity can offer.

Haemoglobinopathies, systemic iron imbalances, bone marrow failure syndromes and nutritional deficiencies causing abnormalities in red blood cell physiology have been associated with male infertility. In this Review, the authors explore the effects of erythrocyte disorders and their treatment on male reproductive health.

In this Review, the authors discuss shared decision-making for prostate cancer screening in terms of definition, prevalence and methods, including decision aids. Facilitators and barriers to shared decision-making are also discussed.

In this Review, the authors examine the potential synergy between thermal ablation and intratumoural immunotherapy in treating localized prostate cancer. This combination could transform the traditionally cold immunological landscape of prostate cancer into a hot one, enhancing treatment efficacy.

Understanding the cell-type-specific mechanisms of cellular dysfunction is necessary to develop precision medicine strategies that promote regeneration of spermatogenesis. In this Review, the authors discuss mechanisms of cellular dysfunction that have been elucidated in non-obstructive azoospermia testicular cells, in both somatic cells and germ cells, and consider how identifying modulators of cellular transcription and translation will be key for future research.

The ureter has mechanical properties that vary along the anatomical length and change with age. In this Review, the authors provide an overview of ureter properties and discuss how understanding the mechanical forces that the ureter is exposed to during clinical interventions can be leveraged to improve surgical outcomes.

MRI and the Vesical Imaging-Reporting And Data System are highly accurate imaging tools for bladder cancer staging. A panel of experts have agreed on their efficacy in different clinical settings for cancer care, using the Delphi methodology. This Expert Recommendation will provide guidance for future research agendas.

Genetic and ancestral factors, molecular pathways involving androgen and non-androgen receptor signalling, inflammation, epigenetics, the tumour microenvironment and tumour metabolism are posited as biological factors that potentially contribute to racial disparities in Black men with prostate cancer.

Sexual interactions between members of the same sex are common but the reasons for these behaviours are not always clear. Results from a study across mammals suggest that increased same-sex behaviour evolved with sociality and might reduce conflict, although increased male–male sexual interactions are associated with increased adult killing.

Senescent stromal fibroblasts exhibit a senescence-associated secretory phenotype, which can promote prostate cancer development, progression and resistance to therapy. Targeting senescent cells via senotherapeutics might be an attractive preventive or therapeutic option for prostate cancer.

Here, the authors describe the history of the efforts to expand knowledge of Wilms tumour biology, genetics, embryonal origin and associated syndromic and familial conditions, and to clinically apply prognostic biomarkers and development of preclinical models.

In this Expert Recommendation, the most pressing questions related to male reproductive health, spanning the spectrum of andrology, are identified. These questions encompass and highlight many opportunities to influence the wellness of future generations.

Much of the Y chromosome has remained obscure owing to the challenge of sequencing repetitive genomic regions. Recently, the Y chromosome has been fully sequenced, revealing extensive heterochromatic areas and 41 new protein-coding genes. Furthermore, 43 Y chromosomes have been sequenced, showing extensive multi-sample variation and providing promising insights into male infertility.

In this Review, the authors provide an overview of currently available diagnostic liquid biopsy biomarkers for renal cell carcinoma, comparing clinical potential and limitations of the three most promising liquid biomarkers: circulating tumour cells, extracellular vesicles and cell-free DNA.

In this Expert Recommendation, the authors provide a standardized nomenclature to improve the Human Phenotype Ontology tree with regard to the classification of non-syndromic male infertility. The implications of introducing this vocabulary in promoting communication across disciplines and institutions and in discovering novel genetic causes of non-syndromic male infertility are also discussed.

Rare male sexual disorders — including post-finasteride syndrome, restless genital syndrome, post-orgasmic illness syndrome, post-SSRI sexual dysfunction, hard–flaccid syndrome, sleep-related painful erections and post-retinoid sexual dysfunction — are under-recognized and under-treated, leading to considerable morbidity, with adverse effects on individuals’ sexual health and relationships. The literature surrounding such disorders is scarce and their aetiology has not been fully elucidated. In this Review, the authors discuss possible aetiologies of these disorders, as well as the need for clinician awareness and large-scale studies to better understand how to best serve patients.