Reviews & Analysis

Paternal substance use is associated with adverse effects on male reproductive health and offspring health outcomes. Comprehensive counselling by health-care providers and improved public health measures, especially targeting reproductive-age men, are needed.

Bladder cancer progression to microscopically distinct variants such as sarcomatoid, small cell, micropapillary and plasmacytoid is associated with more aggressive clinical behaviour than conventional carcinoma. Advances in molecular profiling led to the identification of molecular subtypes of bladder cancer and provided insights into disease progression to aggressive variants.

Ferroptosis induction is a promising new therapeutic strategy for advanced prostate cancer. In this Perspective, the authors discuss the interplay between ferroptosis and metabolism. Current efforts to target ferroptosis and combination therapies in prostate cancer, as well as emerging methods to monitor this process in patients, are also discussed.

In this Review, the authors describe mechanisms through which metabolic disorders and metabolic-related hormonal status affect testes metabolism, spermatogenesis and male fertility. New findings on metabolic-related epigenetic signatures and paternal transgenerational inheritance of metabolic disorders are also discussed.

Robot-assisted kidney transplantation is gaining momentum in kidney transplantation programmes as an alternative approach to patients with end-stage renal disease. In this Review, the authors provide an overview of available evidence on robot-assisted kidney transplantation, particularly in clinically challenging scenarios.

In this Perspective, the authors discuss the idea of targeting histone modifications in bladder cancer, providing a comprehensive overview of findings from preclinical and translational studies. Clinical trials in which the efficacy of molecules targeting histone modifiers was assessed in bladder cancer are also discussed.

The evaluation and management of patients with small renal masses continue to evolve as new data-driven evidence emerges. Contemporary research in biomarkers, imaging, and machine learning shows promise in improving the understanding of small renal masses.

RNA m⁶A modifications have emerged as an important contributor to urological cancer biology. Yang et al. highlight the multifarious roles of m⁶A modifications and discuss the knowledge gap between molecular understanding and clinical applications.

Oxidative stress and reactive oxygen species contribute to the pathophysiology of interstitial cystitis/bladder pain syndrome through their effects on molecular pathways. Here, the authors discuss these pathways, animal models of interstitial cystitis/bladder pain syndrome and treatment options for the disease.

In this Review, the authors describe the molecular profile of bladder cancer progression associated with the subtypes of this disease and comment on their potential diagnostic, prognostic and therapeutic importance.

In the SELENIB trial, selenium and vitamin E were compared with placebo as chemoprevention for non-muscle-invasive bladder cancer (NMIBC). No difference versus placebo was observed in recurrence-free interval (RFI) with selenium, but vitamin E was associated with worse RFI. Selenium and vitamin E cannot be recommended in chemoprevention for NMIBC. Furthermore, patients with NMIBC taking supplemental vitamin E should be made aware of its potential association with worse RFI.

Chromosomal instability is a hallmark of advanced prostate cancer. In this Review, the authors discuss the biological causes and paradoxical consequences of chromosomal instability, its potential clinical role in the stratification of prostate cancer aggressiveness and the development of novel treatment strategies.

African American men are disproportionately affected by prostate cancer in the USA. In this Review, the authors discuss the complex interplay of modifiable risk factors that might underlie the glaring prostate cancer disparities observed.

Muscle-invasive bladder cancer with clinically positive pelvic lymph nodes is a particular situation at the interface between localized and metastatic disease. In this Review, the authors discuss the advances and challenges of currently available strategies for the diagnosis and treatment of patients with muscle-invasive bladder cancer with clinically positive pelvic lymph nodes.

Antiretroviral therapy means that people living with HIV (PLWH) now often have a long life expectancy. However, their risk of developing cancer — most notably virus-related cancers — has been increasing. In this Review, the authors discuss the risk of genitourinary cancers in PLWH, the inequity of health care access and consider how including PLWH in ongoing cancer trials can help to improve cancer care for this population.

The use of English language as the official language in science had an undoubtable role in moving science forward but posed an extra challenge for people whose first language is not English. In this Viewpoint, six non-Native English speakers share their experience as academics, clinicians, researchers and editors who carry out the core tasks of their jobs in a second language, and suggest potential solutions to help overcome issues associated with a linguistic barrier. Their stories show the substantial challenges that non-native English speakers have to face every day regardless of their career status, but also highlight the opportunities that this form of diversity can offer.

Haemoglobinopathies, systemic iron imbalances, bone marrow failure syndromes and nutritional deficiencies causing abnormalities in red blood cell physiology have been associated with male infertility. In this Review, the authors explore the effects of erythrocyte disorders and their treatment on male reproductive health.

In this Review, the authors discuss shared decision-making for prostate cancer screening in terms of definition, prevalence and methods, including decision aids. Facilitators and barriers to shared decision-making are also discussed.

In this Review, the authors examine the potential synergy between thermal ablation and intratumoural immunotherapy in treating localized prostate cancer. This combination could transform the traditionally cold immunological landscape of prostate cancer into a hot one, enhancing treatment efficacy.

Understanding the cell-type-specific mechanisms of cellular dysfunction is necessary to develop precision medicine strategies that promote regeneration of spermatogenesis. In this Review, the authors discuss mechanisms of cellular dysfunction that have been elucidated in non-obstructive azoospermia testicular cells, in both somatic cells and germ cells, and consider how identifying modulators of cellular transcription and translation will be key for future research.