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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.
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.
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.
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.
The gender gap among urologists is narrowing, but representation of women from under-represented in medicine (URiM) groups remains low. URiM women face the added challenge of contending with tokenism. Intentional sponsorship and coaching, as well as institutional efforts to establish an inclusive and equitable workplace culture, are imperative to abolish the lag in promotion and academic achievement of these women.
Several newly approved therapies have substantially altered the treatment paradigm for multiple genitourinary cancers. Considering the existence of numerous possible treatment approaches, understanding which treatment attributes are most valued by each patient is crucial to physicians to recommend a cancer-directed treatment.
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.
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.