Volume 18 Issue 6, June 2021

New technical modifications enable transperineal prostate biopsy to be performed in the ambulatory setting under local anaesthesia. Although a variety of techniques for administration of local anaesthetic during transperineal prostate biopsy have been described, no consensus exists regarding the most effective method to use. Thus, ample opportunity exists for procedural innovation and future study on this topic.

The new Bladder Cancer Research Centre at the University of Birmingham unifies the university’s multidisciplinary bladder cancer research activity within a single research centre, working within five core research themes to translate biomedical science into health-care benefits for patients with bladder cancer.

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.

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.

Diversity in medical fields is beneficial to both clinicians and patients, and Nature Reviews Urology is committed to improving the diversity of our specialty and supporting Black and under-represented minority urologists. In this Viewpoint, 12 medical students who are embarking on a career in urology describe their reasons for choosing the specialty, explain what they think can be done to increase the number of Black urologists, and describe what has led them to apply to specific programmes.

Ductal adenocarcinoma of the prostate is the most common variant histological subtype of prostate cancer. The diagnosis can be challenging and evidence for treatment is predominantly based on retrospective data. This Review discusses the histopathology, characteristics, treatment options and future molecular targets for treatment of this disease.

Devices designed to enhance and diversify sexual pleasure are useful in clinical practice; however, many taboos still seem to exist and the scientific literature on the prevalence, application and effectiveness of sexual devices for therapeutic use is sparse. In this Review, Dewitte and Reisman discuss the clinical use of sex toys and sexual devices, as well as sexually explicit media, across a variety of indications to expand individual and partnered sexuality and to treat sexual difficulties.