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  • Growing evidence suggests that urinary and sexual functional outcomes after radical prostatectomy for prostate cancer differ based on race, with Black men experiencing worse outcomes. Alongside efforts to improve quality and equity, incorporating patient-reported outcomes measures into patient care could improve equity in treatment outcomes for men with prostate cancer.

    • Alexander P. Cole
    • Mara Koelker
    • Caroline M. Moore
    Comment
  • Despite the high prevalence of overactive bladder (OAB) syndrome, its pathophysiology remains poorly understood. Twin studies offer a unique opportunity for studying the genetics of this disorder, but trials are limited by heterogeneous patient populations. Improved understanding of genetic factors in OAB will be vital to developing targeted management.

    • Nicholas Raison
    • Sachin Malde
    • Arun Sahai
    Comment
  • Across health care, clinicians are increasingly using patient-reported outcome measures (PROMs) to give a voice to patients and to help standardize the assessment of patients for comparison purposes. With this increasing use, the limitations of these PROMs should not be underestimated within the diverse population that we treat.

    • Findlay MacAskill
    • Arun Sahai
    • Tet Yap
    Comment
  • Although gynaecology is a specialty responsible for women’s health, the field was historically male-dominated and its science remains biased towards male perceptions of women’s health. In light of the changing social climate in our society and the changing gender composition of the specialty, a number of steps can be taken to make gynaecology more women-centred.

    • Netta Avnoon
    Comment
  • Prostate cancer recurrence is common after radical radiotherapy and the increasing use of novel, minimally invasive salvage treatments means that accurate detection and localization of radiorecurrent disease is vital in treatment planning and delivery. PET–CT is increasingly used to detect metastatic disease; however, data regarding its value for identifying and accurately characterizing intraprostatic recurrence need improvement.

    • Alexander Light
    • Hashim U. Ahmed
    • Taimur T. Shah
    Comment
  • Estimation of post-surgery future glomerular filtration rate (fGFR) is crucial for the oncological management of patients with renal cell carcinoma or urinary tract urothelial carcinoma. A new and simple formula for calculating fGFR has been published and should be included in future guidelines for personalized treatment of patients to guide decisions on surgery, systemic therapies and optimal sequence of treatment.

    • Federico Ferraris
    • Jay D. Raman
    • Jose Rozanec
    Comment
  • Reliable information about sexual and reproductive health and service access during coronavirus disease 2019 (COVID-19) are essential. The International Sexual Health and Reproductive Health (I-SHARE) study is led by a multi-country consortium that adopts an open science approach to achieve this goal. Future work will be needed to assess changes in sexual and reproductive health during the lifting of COVID-19 restrictions.

    • Rayner K. J. Tan
    • Kristien Michielsen
    • Joseph D. Tucker
    Comment
  • Limited information exists regarding the effects of prostate cancer therapies on sexual health outcomes in sexual and gender minority patients. As clinicians, scientists and advocates, understanding these outcomes is imperative in order to enable personalized clinical decision-making and to create a more equitable health system.

    • Daniel R. Dickstein
    • Deborah C. Marshall
    Comment
  • Patients with prostate cancer from sexual minority groups experience considerably worse quality of life following prostate cancer treatment than heterosexual patients. Improved inclusivity as well as cultural humility training at the physician, institution and system levels are warranted to address inequalities in quality-of-life outcomes.

    • David J. Benjamin
    • Arash Rezazadeh
    Comment
  • Incidence and mortality disparities between males and females exist in many diseases including bladder cancer, but the mechanisms remain unclear. To adequately address this issue, researchers must design experiments appropriately, appreciate that sex and gender are not synonymous concepts and understand that the role of both sex and gender in disease need to be elucidated.

    • Dan Theodorescu
    • Zihai Li
    • Xue Li
    Comment
  • Effective mentorship is important for developing trainees and faculty in urology. Crucial aspects of mentorship are necessary to create long-lasting mentorship relationships, to enhance faculty mentorship and to promote diversity and equity in urology. Innovative strategies to address challenges and opportunities are necessary to enhance the legacy of mentorship.

    • Hiren V. Patel
    • Nathan M. Shaw
    • Benjamin N. Breyer
    Comment
  • Recommendations for children and adolescents with single kidneys (like most survivors of Wilms tumour) for taking part in contact sporting activities are not aligned worldwide. This discrepancy can create misunderstandings regarding the perceived and real risk of abdominal impact and trauma when practising some sports.

    • Filippo Spreafico
    • Giovanna Gattuso
    • Maura Massimino
    Comment
  • Malnutrition is a potentially modifiable factor that is associated with considerable morbidity and is prevalent in patients with bladder cancer who are treated with radical cystectomy. Studies suggest a role for immuno-nutrition in optimizing patients’ nutritional status before undergoing this procedure, with the goal of improving patient outcomes.

    • Muhannad Alsyouf
    • Hooman Djaladat
    • Siamak Daneshmand
    Comment
  • Prostate cancer disproportionately affects Black men; the reason for this phenomenon is unclear. The role of the health-care provider is important in screening for prostate cancer, advising on treatment and ensuring completeness of therapy. Cultural competency is necessary in health-care providers as, for most men in Europe, Australasia and the USA, the ethnicity and/or race of the urologist will be discordant with that of the patient.

    • Francis I. Chinegwundoh
    Comment
  • Focus on quality of life after prostate cancer is vital to improve patient care. Improved assessment and proactive management of post-treatment functional outcomes is essential. Many aspects of the patients’ aftercare need to be improved in order to set up a clear path following prostatectomy. These improvements will enable a timely and efficient escalation of treatment and ameliorate patients’ survivorship experience.

    • Findlay MacAskill
    • Arun Sahai
    • Sachin Malde
    Comment
  • The new Bladder Cancer Research Centre at the University of Birmingham unifies the university’s multidisciplinary bladder cancer research activity within a single research centre, working within five core research themes to translate biomedical science into health-care benefits for patients with bladder cancer.

    • Richard T. Bryan
    • Roland Arnold
    • Douglas G. Ward
    Comment
  • Mobile health (mHealth) technologies hold great potential to advance medical care. However, widespread adoption in urology, and medicine in general, has been limited by a host of factors. Recognition of these barriers to adoption may instruct more meaningful tool development and investigation in order to unlock the full potential of these digital health tools in our field.

    • Jared S. Winoker
    • Kevin Koo
    • Brian R. Matlaga
    Comment
  • New technical modifications enable transperineal prostate biopsy to be performed in the ambulatory setting under local anaesthesia. Although a variety of techniques for administration of local anaesthetic during transperineal prostate biopsy have been described, no consensus exists regarding the most effective method to use. Thus, ample opportunity exists for procedural innovation and future study on this topic.

    • Spyridon P. Basourakos
    • Mathew J. Allaway
    • Michael A. Gorin
    Comment
  • The COVID-19 pandemic has resulted in a substantial increase in waiting times for cystoscopies, prompting concerns of delayed diagnoses and substandard surveillance of bladder cancer. Expanding the role of urinary biomarkers in diagnostic and surveillance pathways could be a strategy to address this problem, and several novel biomarkers have shown promise for this purpose.

    • Kenrick Ng
    • Krishna Vinnakota
    • Nikhil Vasdev
    Comment
  • In medicine and society exist two pandemics. One, COVID-19, has recently emerged and has been widely acknowledged. The other — systemic racism — has been silently deadly for centuries. Now is the time to recognize the impact of this other pandemic and to eradicate it.

    • Randy A. Vince Jr
    • Kristen R. Scarpato
    • Adam P. Klausner
    Comment