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This issue includes a Review on precision oncology in advanced prostate cancer and a Perspective on landmarks in the development of vaginal mesh.
Image of prostate cancer patient-derived organoids supplied by Hatem Sabaawy, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA. Cover design: Patrick Morgan.
Improved tools for diagnosis, treatment and basic research into the mechanisms of urological disease have transformed our field over the past 15 years. However, building on these advances relies on continued collaboration, teamwork and data sharing across our specialty.
The future of urology holds promising new technologies but also a challenging increase in urological care needs. To translate emerging technologies and medical advances into use and accommodate the growing demand for urological services, we need strong collaboration with other health-care professionals within urology, other medical specialties and the community that surrounds our profession.
As a field that embraces technology, urology has evolved quickly in the past 15 years and is likely to change at an even greater pace in the next 15. Several approaches and initiatives have the potential to improve patient care, in particular the use of telemedicine, improvements in data analytics and growth of physician collaboratives.
The Internet can be a valuable resource for patients, but it is also a minefield of misinformation and hidden bias. The Urology Care Foundation is attempting to mitigate this flood of inaccurate information by providing high-quality online resources for clinicians, patients and caregivers.
Clinical and pathological risk grouping defines management in localized prostate cancer. Recent work suggests men with high-risk prostate cancer can be further subdivided into three risk groups (favourable high-risk, standard high-risk and very-high-risk) and that these groups correlate with measures of genomic risk, testing of which is increasingly being integrated into risk prediction.
In a recently published study, surveys of transgender individuals on hormone therapy provide insight into the self-reported effects of medication where previous thinking was only speculative. Still, controlled studies are required to avoid overinterpreting the clinical significance of specific findings in the context of what might be expected in the general population.
A number of targetable molecular alterations and resistance mechanisms have been identified in metastatic castration-resistant prostate cancer (mCRPC). As our understanding of the genomic landscape of mCRPC increases, biomarker-driven clinical trials investigating targeted therapies will enable an increasingly personalized approach to its treatment.
The molecular mechanisms involved in papillary renal cell carcinoma (pRCC) development and drug resistance are diverse. In this Review, the authors summarize the current understanding of the mechanisms of resistance to currently used therapies in pRCC and make recommendations for future preclinical and clinical studies.
In this timeline, the authors describe the evolution of the use of polypropylene mesh in female pelvic floor surgery. They detail how the material properties of mesh relate to the occurrence of complications and discuss approaches to developing new materials and tissue engineering techniques.