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The urological workforce in the United States is substantially affected by inequitable abortion access across the nation. Female residency applicants avoid states with restrictive laws, and women urologists residing in these states are considering leaving. The urological community needs to invest in advocacy to protect the health of their members.

In this Review, the authors provide an overview of the role of calcium as a driver of prostate cancer onset and progression, and discuss the most current therapies targeting the calcium signalling machinery to treat this malignancy.

Conversations around pregnancy and parenting in medicine are increasingly important, especially as the number of women in medical training increases. Common challenges are experienced by women during pregnancy, parental leave, return to work and lactation, and policy suggestions can be offered to support doctors and surgeons who want to expand their families.

Burnout is prevalent among urologists and leads to increased medical errors and decreased career satisfaction. Lack of access to mental health care and long work hours contribute to burnout in urologists; however, gender bias in the workplace, mistreatment and balancing family life responsibilities specifically predispose women urologists to burnout.

In this Review, Nolla and colleagues discuss the use of patient-reported outcome measures (PROMs) to assess health-related quality of life in six immunotherapy versus sunitinib clinical trials for advanced renal cell carcinoma and, following this discussion, make recommendations for future PROM use in clinical trials.

The cellular action of SARS-CoV-2, the virus responsible for the COVID-19 global pandemic, is dependent on a specific combination of receptors and cofactors. These proteins are now known to be expressed in normal kidney tubule tissue and renal cell carcinoma cells, representing possible targets for budding therapeutic modalities.

Women urologists receive less compensation than male urologists. Concerted individual and institutional action is necessary to value the impact that women urologists have on patients and on the entire field.

The field of medicine has advanced towards gender equity in medical student matriculation over the past decade, but urology has lagged substantially behind other sub-specialties regarding the percentage of both women residents and women staff. This gender gap is further increased for under-represented individuals in medicine. One of the strategies to close these gaps is to create an inclusive work environment through allyship.

In this Perspective, current evidence to support de-escalation strategies of attenuated chemotherapy, radiotherapy and surgery for stage II seminoma to minimize the toxic effects of treatment is described and new potential de-escalation strategies are discussed.

In this Review, current vaccine-based approaches to treat prostate cancer are described. The authors discuss results from clinical trials in which overall vaccine safety and biological activity were shown, albeit with modest clinical activity, suggesting that the future of these approaches will be as part of combination therapies with agents targeting tumour-associated immune mechanisms of resistance.

The number of women entering the historically male-dominated field of urology is growing over time, but women in urology are disproportionately younger than the male counterpart and face unique challenges that require intentionally directed mentorship. In this Comment, some of these issues are discussed from the perspective of both the female mentee and mentor.

Focal ablative therapy has emerged as a treatment option in radio-recurrent prostate cancer to obtain local control of disease and spare patients severe salvage-treatment-related complications. Irreversible electroporation holds the potential to become the standard ablative modality in prostate cancer owing to reliable ablation results, the electricity-based effect and an acceptable adverse-effect profile.

Women urologists constitute an increasing proportion of the urology workforce in the United States. Considering the projected shortage of urologists over the coming decades, women urologists will have a crucial role in the delivery of urological care. Opportunities for recruitment and retention of women in the field of urology must be highlighted.

Artificial intelligence (AI) has rapidly become one of the most important and transformative technologies of our time, with applications in virtually every field and industry. Among these applications, academic writing is one of the areas that has experienced perhaps the most rapid development and uptake of AI-based tools and methodologies. We argue that use of AI-based tools for scientific writing should widely be adopted.