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  • Andolfi et al. report on the largest single-institution case series of robot-assisted laparoscopic pyeloplasty (RAL-P) in infants. Transitioning from RAL-P in older children to infants seems to have more to do with patient and port positioning, instrument size and intra-abdominal space than robotic surgical technique.

    • Marie-Klaire Farrugia
    News & Views
  • Serum PSA testing can identify men with clinically significant prostate cancer but exposes many more men to the diagnosis of indolent tumours. Benafif and colleagues have published the results of the BARCODE1 pilot study, in which they propose using germline single-nucleotide polymorphisms to identify men with a genetic risk of developing prostate cancer. Based on their preliminary findings, changing the current prostate cancer screening paradigm will be a challenge.

    • Peter C. Albertsen
    News & Views
  • Balancing diversity on panels at academic medical conferences demonstrates a commitment to the principles of diversity and inclusion. However, it seems we have a long way to go in urology, where two-thirds of sessions at major urology meetings still consist of all-male speaker panels.

    • Imogen Patterson
    • Sigrid V. Carlsson
    News & Views
  • The treatment of patients with the PD1 inhibitor pembrolizumab yields benefit in the second-line metastatic urothelial cancer setting. Two new trials have studied pembrolizumab monotherapy in other patients with urothelial carcinoma: an open-label phase II trial has enrolled patients with high-risk BCG-refractory non-muscle-invasive disease, and a phase III trial has compared three first-line treatment options for patients with metastatic disease. However, these trials have shown conflicting results.

    • Jeanny B. Aragon-Ching
    News & Views
  • Radiotherapy is one of the most effective modalities for cancer treatment, but radiation-associated secondary malignancies are important potential morbidities. Here, we highlight a recent article that examines radiation-associated muscle-invasive bladder cancer and explore how we as clinicians should consider the management of secondary malignancies.

    • Vishruth K. Reddy
    • Neha Vapiwala
    News & Views
  • A new phase I clinical trial has demonstrated that belzutifan provides a route to sustained inhibition of hypoxia-inducible factor 2α in humans that is well tolerated and could be useful in the treatment of advanced clear cell kidney cancer.

    • Natalie Burrows
    • Patrick H. Maxwell
    News & Views
  • Evidence for the existence of racial disparities in semen parameters is increasing, exemplified by a recent study in men from white, Black and Asian populations. However, reference standards for semen parameters might not account for these disparities.

    • Francesco Del Giudice
    • Michael L. Eisenberg
    News & Views
  • Most localized prostate cancer can be cured with radiotherapy. Over the past decade, treatment courses have been shortened with no deterioration in cure rate or adverse effects. Now, a small phase II trial has tested whether radiation could be delivered as a single treatment.

    • Alison C. Tree
    • Nicholas J. van As
    News & Views
  • The BJU International paper by van de Grift and colleagues includes important data outlining the long-term cosmetic and functional outcomes for masculinizing surgery in patients born with differences in sex development. This overview highlights some of the important findings and their context in what can be a controversial subject.

    • Dan Wood
    • Duncan Wilcox
    News & Views
  • COVID-19 has had a substantial effect on patients with kidney stones, such as delays in care and increased anxiety and use of opioids. Mitigating these effects in the future could involve an online physician-based discussion as a part of the overall treatment strategy to help patients with their queries, apprehensions and ultimately their decision-making.

    • Bhaskar Kumar Somani
    News & Views
  • With increasing global life expectancy comes increasing health conditions. Robotic-assisted radical prostatectomy (RARP) is traditionally offered to patients under the age of 75 years. However, a new study on RARP in patients aged over 75 years has demonstrated outcomes that will challenge this convention.

    • Edward Calleja
    • Peter Rimington
    News & Views
  • Radical cystectomy is advocated for patients with high-risk non-muscle-invasive bladder cancer who develop disease recurrence following BCG therapy. A retrospective series suggests that a delay in radical cystectomy attributable to failure of salvage bladder-preserving therapies in this patient cohort is safe. However, a closer analysis of the study reveals inherent case selection that might limit such conclusions.

    • Wei Shen Tan
    • John D. Kelly
    News & Views
  • More than 50 clinical trials are currently exploring the combination of immunotherapy and other approved treatments for advanced prostate cancer. The results from a phase II trial of sipuleucel-T with or without radium-223 in patients with metastatic castration-resistant prostate cancer were recently published with intriguing findings.

    • Abhishek Srivastava
    • Neal D. Shore
    News & Views
  • Genomic alterations in metastatic castration-resistant prostate cancer can be identified in plasma circulating tumour DNA. A large cohort analysis shows reliable detection of clinically relevant alterations through targeted cell-free DNA sequencing with a commercial platform, paving the way for liquid biopsy technology to be integrated into routine clinical practice.

    • Sarah W. S. Ng
    • Alexander W. Wyatt
    News & Views
  • An effective transurethral resection of bladder tumour (TURBT) is essential to achieve safe tumour clearance and to determine the biological potential of the cancer. Attention to surgical detail within a set-up that embraces evidence-based practice, training, quality standards, prospective audit and feedback will facilitate these objectives.

    • Paramananthan Mariappan
    News & Views
  • The value of proton therapy in managing prostate cancer is not yet defined. A recent study has reported promising long-term results for patients with localized prostate cancer who received proton therapy. However, results from ongoing clinical trials are required before determining the role of proton therapy for this indication.

    • Curtis M. Bryant
    • Bradford S. Hoppe
    News & Views
  • Adiposity and skeletal muscle mass have been shown to be prognostic for mortality in several cancers. In a recent study, CT imaging at diagnosis was used to determine whether components of body composition were associated with survival in men with advanced prostate cancer.

    • Ilona Csizmadi
    • William J. Aronson
    News & Views
  • MRI has become an established tool in the diagnosis, management and treatment of localized prostate cancer. However, standardized guidelines on reporting prostate MRI have not yet been developed. A recent consensus study proposes a certification framework for reporting prostate MRI in the UK.

    • Baris Turkbey
    • Bradford J. Wood
    News & Views
  • Rare genitourinary cancers have historically been challenging to treat given the scarcity in incidence, inadequacy of data on treatment and lack of general consensus to guide routine therapy. A phase II multicentre trial shows efficacy of nivolumab and ipilimumab in several cohorts of patients with rare genitourinary cancers.

    • Jeanny B. Aragon-Ching
    News & Views
  • A new study reports that selected patients with short life expectancy can safely undergo partial nephrectomy with perioperative outcomes that approximate those of patients with long life expectancy. The authors suggest that extensive centre and/or surgeon experience, a robot-assisted approach, and off-clamp and simple enucleation techniques might facilitate favourable outcomes in these challenging patients.

    • Steven C. Campbell
    • Rebecca A. Campbell
    News & Views