Articles in 2020

Disruption of the circadian clock has been associated with pathological conditions including obesity, type 2 diabetes mellitus, cancer, depression and neurodegenerative diseases. Disturbed sleep patterns have now been associated with reduced erectile function. The mechanisms behind this effect are unclear but could include hypoxia signalling and low testosterone.

Antimicrobial resistance in Neisseria gonorrhoeae compromises gonorrhoea treatment worldwide. Novel and optimized treatments and/or treatment strategies that effectively eradicate the infection with low selection of resistance are imperative. A new prospective clinical study provides further evidence that resistance-guided treatment of gonorrhoea with single-dose oral ciprofloxacin is efficacious in relevant settings and can reduce the selection pressure for resistance.

Pooled clinical trial data reveal that antibiotics worsen progression-free survival and overall survival in patients with locally advanced and metastatic urothelial cancer receiving anti-PDL1 therapy. Consensus guidelines for antibiotic use in these patients, as well as diagnostic tools and corrective measures, are needed to decrease primary resistance to immune checkpoint inhibitors.

Renal cell carcinoma (RCC) incidence is increasing worldwide. Here, the authors consider the potential benefits and harms of screening for RCC and discuss whether enough evidence is available to begin a clinical trial of RCC screening.

Complicated UTI (cUTI) incidence and the prevalence of antibiotic resistance among uropathogens are increasing. Here, the authors discuss different cUTI classification systems, describe current understanding of the aetiology of cUTIs and outline clinical studies of novel antibiotics in patients with cUTIs or pyelonephritis and the use of UTI as a model for other infection types in clinical studies.

Personalized decision-making is the ultimate goal of managing men with lower urinary tract symptoms caused by benign prostatic obstruction. Urodynamics can provide valuable information in these patients and a recent multicentre randomized trial has highlighted important findings warranting consideration, as well as indicating that further insights are needed.

The COVID-19 pandemic has undoubtedly put a strain on relationships. For some couples, lockdown has meant long periods of separation, whereas for others, lockdown has resulted in months of isolation together. In this Viewpoint, three experts consider the effects of the pandemic on relationships and suggest ways in which lockdown can become a positive experience for couples making love in the time of corona.

In this Review, Aydin et al. discuss our current knowledge of the genomic, molecular and immunological make-up of penile squamous cell carcinoma and the findings of research studies to explore future therapeutic approaches in this disease.

Sharpley et al. describe the prevalence and effects of depression in men with prostate cancer and explore the causes and factors contributing to depression. They discuss depression definitions applicable to this patient population, how depression can be identified in the clinical setting and treatment considerations.

The Movember global Landscape Analysis Committee (LAC) was established to act as an independent group of experts across urology, medical oncology, radiation oncology, radiology, pathology, translational research, health economics and patient advocacy to identify the highest priority research needs across the prostate cancer biomedical research domain. Findings from the landscape analysis illustrate the research priorities in prostate cancer and will enable Movember to focus on specific needs, with particular investment in research to reduce disease progression and improve therapies for advanced prostate cancer.