Pride 2023

Sexual health and treatment-related sexual dysfunction in sexual and gender minorities with prostate cancer

In this unique Review, Dickstein et al. discuss the prostate as a sexual organ and the effects of prostate cancer treatment on sexual outcomes in gender minority patients


  • Two women converse in front of a laptop

    Nature Reviews Urology is committed to facilitating training in peer review and to ensuring that everyone involved in our peer-review process is appropriately recognised. We have, therefore, joined an initiative to allow and encourage established referees to involve one early-career researcher in our peer-review process.


    • Sexually transmitted infections (STIs) remain public health concerns. Doxycycline post-exposure prophylaxis to prevent STIs is a novel promising intervention, which in a new study caused an ∼65% reduction in incident STIs. However, long-term effects on STI prevalence, microbiomes and antimicrobial resistance among STI pathogens, non-STI pathogens and commensals need to be monitored.

      • Magnus Unemo
      • Fabian Yuh Shiong Kong
      News & Views
    • The current serum tumour markers α-fetoprotein, human chorionic gonadotrophin, and lactate dehydrogenase show limited value for testicular cancer relapse detection. A recent study highlights that false-positive elevations in follow-up monitoring are common and, conversely, many patients do not have elevations despite proven relapse. These findings highlight the potential for circulating microRNAs to be used as improved biomarkers for relapse detection.

      • Matthew J. Murray
      • Cinzia G. Scarpini
      • Nicholas Coleman
      News & Views
    • Urine markers enable non-invasive acquisition of tumour information. The evolution towards multiplex approaches addresses bladder cancer heterogeneity and expands clinical application scenarios for urinary biomarkers. This Review provides a comprehensive overview of current status, limitations and perspectives of various urine markers.

      • Moritz Maas
      • Tilman Todenhöfer
      • Peter C. Black
      Review Article
    • Effects of prostate cancer treatment in sex and gender minority groups, which include gay and bisexual men, transgender women, or transfeminine people, can include altered sexual function in relation to receptive anal and neovaginal intercourse and changes to patients’ role-in-sex, as well as changes in sexual pleasure related to the loss of the prostate as a source of sexual pleasure. In this Review, the authors discuss the prostate as a sexual organ and consider the effects of prostate cancer treatment in patients from these under-represented groups, as well as discussing the need for openness and counselling in patients from sexual and gender minorities.

      • Daniel R. Dickstein
      • Collin R. Edwards
      • Deborah C. Marshall
      Review Article
    • Current evidence suggests that adipose stromal cells, a component of peri-prostatic white adipose tissue and the tumour microenvironment, have an important role in driving aggressive prostate cancer in obesity. These cells are potential targets of therapies to suppress cancer aggressiveness in obesity.

      • Achinto Saha
      • Mikhail G. Kolonin
      • John DiGiovanni
      Review Article
  • Clinic-based uroflowmetry is limited by a short window of data collection and inefficient data transmission. Obtaining uroflowmetry data in the home setting has the potential for increased data on voiding patterns to inform clinical decision-making. However, integration of this practice depends on optimizing technology and data management.

    • Zoe S. Gan
    • Stephen A. Zderic
  • Transgender women remain at risk of prostate cancer and warrant consideration for PSA screening. However, current PSA reference ranges and guidelines are based on data from cisgender men. As these thresholds might be inappropriate in transgender women receiving gender-affirming hormones, we recommend that these patients should undergo screening for prostate cancer at regular intervals and further evaluation for PSA >1 ng/ml or rising PSA. Furthermore patient-centred dialogues should be initiated with patients to ensure awareness of prostate cancer risk.

    • Farnoosh Nik-Ahd
    • Jennifer T. Anger
    • Stephen J. Freedland
  • High intensity theatre (HIT) lists are an efficient and effective measure to tackle elective surgery backlogs without compromising outcomes and safety compared with traditional elective lists. A recent pilot trial in standard and complex urological surgery at a tertiary hospital in the UK proved successful for both the patients and the staff involved.

    • Marc A. Furrer
    • Imran Ahmad
    • Ben Challacombe
    Clinical Outlook
  • Urology is a historically male-dominated field and, although the number of women is increasing, gender equity is still far off. All members of the urology community need to work together to drive a change.