Reviews & Analysis

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  • Several studies over the past few decades have suggested that sperm quality varies by geographical region and might be subject to a temporal decline worldwide. However, the data supporting these conclusions have come from studies of various methodologies and heterogeneous populations, making them unreliable. In this in-depth Review, Chevrier and colleagues discuss the data surrounding discussion of spatiotemporal trends in semen parameters and consider how these trends and the factors promoting them interact.

    • Jacques Auger
    • Florence Eustache
    • Bernard Jégou
    Review Article
  • Diabetic bladder dysfunction (DBD) is a common complication of diabetes. Hyperglycaemia-induced oxidative stress is thought to mediate functional changes in organs and tissues affected by DBD. In this Review, the authors provide an overview of mechanisms and consequences of oxidative stress, focusing on the role of diabetes-induced oxidative stress in generating dysfunctions at the level of the urothelium, smooth muscle contractility and nerve structures involved in DBD pathogenesis.

    • Qi-Xiang Song
    • Yi Sun
    • Margot S. Damaser
    Review Article
  • In this Review, the authors discuss racial differences in the prevalence of genetic mutations in the main molecular drivers of prostate cancer and provide input regarding the role of genomics in racial disparities observed in prostate cancer outcomes.

    • Camilo Arenas-Gallo
    • Jude Owiredu
    • Jonathan E. Shoag
  • Muscle-invasive bladder cancer (MIBC) remains a deadly disease, despite aggressive surgical and systemic chemotherapeutic treatments. New treatment modalities are needed. A novel intravesicle drug delivery device for neoadjuvant treatment of MIBC has been developed, and preliminary results on the efficacy and safety of this system are available.

    • Katherine M. Rodriguez
    • Max Kates
    News & Views
  • In this Review, Joshi and colleagues describe the immune landscape of penile cancer, examine existing and novel immune-based therapeutic targets, and discuss the future directions of immune-based therapies in penile cancer based on preclinical and clinical studies.

    • Vidhu B. Joshi
    • Philippe E. Spiess
    • Jad Chahoud
    Review Article
  • In this Perspective, the authors discuss the complex links among inflammation, dysbiosis, ageing and cancer, examining data that suggest that ageing and inflammation can promote bladder cancer development, how ageing might lead to or promote dysbiosis, and how dysbiosis could influence treatment response.

    • Austin Martin
    • Benjamin L. Woolbright
    • John A. Taylor III
  • In this Review, the authors discuss the current evidence for the use of prostate-specific membrane antigen (PSMA) PET and whole-body (WB) MRI, consider the evolving use of PSMA PET-derived and WB MRI-derived quantitative biomarkers and make recommendations for future clinical trials of these modalities.

    • Yishen Wang
    • Joao R. Galante
    • Veeru Kasivisvanathan
    Review Article
  • In this Review, the authors summarize current advances in our understanding of the roles of stroma and associated extracellular matrix during bladder cancer development, describing the bladder tumour microenvironment and introducing the concept of the metastatic tumour microenvironment.

    • Yu-Cheng Lee
    • Hung-Ming Lam
    • Keith Syson Chan
    Review Article
  • Hyperactivation of innate immunity is a disease determinant in urinary tract infections (UTIs). Modulation of innate immunity has promise as a therapy for UTIs. In this Review, the authors discuss potential mechanisms and immunomodulatory therapeutic strategies in UTIs.

    • Daniel Butler
    • Ines Ambite
    • Catharina Svanborg
    Review Article
  • The three-piece inflatable penile prosthesis offers an excellent treatment option for some men with erectile dysfunction, but implant surgery is not without surgical risks and can carry additional cosmetic and psychosocial consequences in poorly selected and consented individuals. In this Consensus Statement, an international group of key opinion leaders and high-volume prosthetic surgeons review the current guidelines and clinical evidence and present their expert consensus regarding patient selection, technique and complications of inflatable penile prosthesis surgery.

    • Eric Chung
    • Carlo Bettocchi
    • Gerald Brock
    Consensus Statement
  • The BIONIKK trial is the first prospective biomarker-driven randomized trial in metastatic clear cell renal cell carcinoma. This trial demonstrates the feasibility of using a transcriptomic biomarker that reflects intrinsic disease biology to optimize treatment efficacy and shows that all patients might not require combination treatment.

    • Eduard Roussel
    • Benoit Beuselinck
    • Maarten Albersen
    News & Views
  • The highest risk of death from prostate cancer is associated with increased waist circumference, increased blood pressure, hypertension, type 2 diabetes and obesity; thus, therapies that can reduce blood glucose levels have the potential to improve patient outcomes. The therapeutic benefits of low-carbohydrate and fasting-mimicking diets in patients with prostate cancer have been investigated in two recent studies.

    • Thomas N. Seyfried
    News & Views
  • Standard-of-care management of renal cell carcinoma (RCC) relies on surgery for low-risk localized disease and systemic treatment for poor-prognosis metastatic tumours, but patients with high-risk localized tumours and with metastatic disease that has a good-to-intermediate prognosis are in a grey area for treatment. In this Review, the authors provide a comprehensive overview of the current knowledge on surgery and systemic treatment in the management of metastatic and localized RCC.

    • Alexandre Ingels
    • Riccardo Campi
    • Alexandre de la Taille
    Review Article
  • The sixth edition of the WHO (World Health Organization) semen analysis manual has been released 10 years after the previous edition and includes important updates. In this Perspective article, a comprehensive overview and discussion of the newly released WHO manual are provided. Limitations of routine semen analysis-based infertility assessment and potential solutions to improve male infertility work-up are also discussed.

    • Sandro C. Esteves
  • Since calcium/calmodulin-dependent kinase kinase 2 (CAMKK2) was identified as an androgen-receptor-regulated gene, important functional roles of CAMKK2 in prostate cancer progression have been shown in preclinical models. In this Perspective, the authors present evidence supporting an oncogenic role of CAMKK2, and also discuss mechanisms of regulation and emerging non-cell-autonomous roles of CAMKK2. Moreover, the potential use of CAMKK2 as a biomarker and/or therapeutic target in prostate cancer is discussed.

    • Thomas L. Pulliam
    • Pavithr Goli
    • Daniel E. Frigo
  • In this Review, Russo and Giri describe and discuss germline testing criteria, genetic testing strategies, genetically informed screening, precision management, delivery of genetic counselling or alternative genetic services and special considerations for men with prostate cancer.

    • Jessica Russo
    • Veda N. Giri
    Review Article
  • In this Review, the authors describe our current knowledge of the consequences of SARS-CoV-2 infection on the urogenital system, discussing urological symptoms and damage to organs of the genitourinary tract induced by COVID-19 infection. Moreover, the effects of COVID-19 on male fertility and sexual health are discussed.

    • Benedikt Ebner
    • Yannic Volz
    • Giuseppe Magistro
    Review Article
  • Active surveillance is recommended for low-risk and favourable intermediate-risk prostate cancer management, but active monitoring using imaging or biopsy is necessary to compensate for initial undergrading of the tumour or to detect early progression without missing the opportunity to provide curative therapy. In this Review, the authors discuss the potential for MRI-based active monitoring for active surveillance and consider how this approach might affect patient care.

    • Guillaume Ploussard
    • Olivier Rouvière
    • Raphaële Renard-Penna
    Review Article
  • Prognostic models incorporating clinical and pathological parameters might assist clinicians in counselling and surveillance of patients following surgical resection of renal cell carcinoma (RCC). Variability exists in the risk classification of individual patients in each model as well as the performance of each model in different RCC subtypes.

    • Thomas Gerald
    • Vitaly Margulis
    News & Views