Reviews & Analysis

Neuromodulation has been used in the treatment of overactive bladder for almost 40 years. Several studies have confirmed its clinical effect. In this Review, existing evidence related to the mechanism of action of neuromodulation is synthesized.

In some instances (<5%), non-muscle-invasive bladder cancer can progress to metastatic disease without any signs of bladder muscle or lympho-vascular invasion, a condition known as metastatic non-muscle-invasive bladder cancer. In this Perspective, the authors present the available literature on metastatic non-muscle-invasive bladder cancer, and discuss the potential aetiologies underlying this condition.

The circadian rhythm has a crucial role in regulating nocturia. In this Review, the authors discuss how the brain–kidney–bladder circadian axis can lead to nocturia, prompted by the rationale that understanding these disruptions can lead to developing effective treatments _targeting circadian rhythms.

In this Review, the authors provide an overview of molecular imaging in renal cell carcinoma, discussing the role of molecular imaging approaches in renal cell carcinoma diagnosis, treatment and response monitoring.

A common germline missense-encoding polymorphism in HSD3B1, called the adrenal-permissive allele, facilitates androgen synthesis from adrenal precursors via increased 3β-hydroxysteroid dehydrogenase 1 (3βHSD1). Here, the authors focus on mechanistic and clinical investigations of 3βHSD1 and the clinical consequences and potential utility of detecting adrenal-permissive allele inheritance.

High-fat diets disrupt testicular function by accumulating lipids, impairing sperm production and affecting the cytoskeleton of spermatogenic cells. This Perspective aims to understand these mechanisms to develop treatments for infertility in men with obesity.

Metastatic urothelial cancer exhibits substantial molecular heterogeneity compared with the primary tumour, complicating the development of accurate biomarkers. Pre-treatment metastatic biopsies capture real-time tumour biology and can enhance response predictions for _targeted therapies, improving patient selection for precision oncology.

Examination of racial disparities in prostate cancer in the USA and UK highlights systemic, socio-economic and sociocultural factors that might contribute to these differences. Understanding behavioural medicine might inform and improve the way in which the health-care system can engage with patients in minorities who are affected by this disease.

Feedback mechanisms between androgen and IGF1 signalling pathways have been linked to the development, progression and hormone refractoriness of prostate cancer. In this Review, the dynamic regulation of androgen and IGF1 signalling in prostatic epithelia and stroma are described and the implications for future preventative and therapeutic strategies are explored.

Here, the authors describe the evidence concerning plant-based dietary patterns and omnivorous diets with reduced consumption of animal-based food and increased consumption of plant-based foods and their associations with the most common urological cancers and benign urological conditions.

In this Perspective, the authors discuss our current knowledge of the use of the metaverse in surgery and its potential applications, highlighting challenges and opportunities. The ethical, legal and public health implications of integrating the metaverse into surgery are also discussed.

This Perspectives provides an overview of life-cycle assessment and its use in urological academic literature to date. The authors explain how life-cycle assessment can be interpreted and used to help to reduce the environmental impact of urology.

In this Perspective, the authors present the state of the art of vascularized composite bladder allograft transplantation in humans, discussing different surgical approaches used in the attempts carried out so far, as well as currently available diversion methods. The role of tissue engineering in the field of urinary bladder regeneration is also discussed.

Artificial intelligence can be leveraged to improve the detection of prostate cancer on magnetic resonance imaging; however, before this technology is implemented in clinical practice, further research is required.

Mounting evidence indicates that sperm RNAs have important functions in spermatogonial processes and are potential markers in the diagnosis of and decision-making for male idiopathic infertility. Here, the authors describe current evidence and suggest necessary future studies to translate this evidence into clinical practice.

PIONEER is a European network of excellence for big data in prostate cancer, which brings together private and public stakeholders from nine countries in one multidisciplinary research consortium. In this Perspectives, members of the consortium detail the achievements of PIONEER and describe its goal of maximizing the potential of big data to improve prostate cancer care in the future.

In this Perspective, the authors provide an overview of the most promising deregulated non-coding RNAs in clear-cell renal cell carcinoma, discussing the role of different classes of non-coding RNAs in clear-cell renal cell carcinoma development and progression. Future perspectives and challenges associated with the translation of these markers into clinical practice are also discussed.

In this Review, the authors provide a comprehensive overview of videourodynamics, discussing terminology, technique, findings, limitations and future perspectives associated with this approach.

This Review focusses on what is known about the interactions between conventional radiotherapy and the immune system. The authors discuss how this knowledge can be applied to investigate gaps regarding the immune interactions of molecular radiotherapies.

Lutetium PSMA is approved for the treatment of advanced prostate cancer and is being studied in a neoadjuvant setting. The influence of lutetium PSMA on the tumour immune microenvironment is unknown. In selected patients, lutetium PSMA could be used as a stand-alone treatment or in combination with immunotherapy to produce long-lasting antitumour immunity.