{"title":"Breaking the silence: normalizing receptive anal intercourse for patients, for people and for myself","authors":"Daniel R. Dickstein","doi":"10.1038/s41585-024-00892-w","DOIUrl":"10.1038/s41585-024-00892-w","url":null,"abstract":"The lack of information and discussion on receptive anal intercourse (RAI) perpetuates the stigma. Normalizing RAI and empowering individuals to embrace their sexuality without shame or judgement requires us to confront biases, foster dialogue and break the silence.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 6","pages":"317-318"},"PeriodicalIF":15.3,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140881297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Massari, Matteo Rosellini, Veronica Mollica
{"title":"Overall survival with adjuvant pembrolizumab in renal cell carcinoma — the shock of the lightning","authors":"Francesco Massari, Matteo Rosellini, Veronica Mollica","doi":"10.1038/s41585-024-00896-6","DOIUrl":"10.1038/s41585-024-00896-6","url":null,"abstract":"In the KEYNOTE-564 trial, patients with resected clear cell renal cell carcinoma at a high risk of relapse experienced disease-free survival and especially overall survival benefits following treatment with pembrolizumab, which in turn was established as the novel standard adjuvant therapy for these patients. Accurate patient selection is crucial. Managing post-pembrolizumab recurrence is challenging owing to limited evidence for guiding therapeutic decisions based on clinical features.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 10","pages":"578-579"},"PeriodicalIF":12.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140953371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Danly Omil-Lima, Austin Thompson, Kyle Scarberry, Benjamin Crawshaw
{"title":"Promoting the health of men of all backgrounds: educating ourselves to build trust and improve care","authors":"Danly Omil-Lima, Austin Thompson, Kyle Scarberry, Benjamin Crawshaw","doi":"10.1038/s41585-024-00893-9","DOIUrl":"10.1038/s41585-024-00893-9","url":null,"abstract":"Specific issues affect the treatment of urological cancer and survivorship in gay and bisexual men. Creating an accepting and inclusive environment for these patients in our men’s health clinics can help to improve the quality of life for men from sexual minority groups undergoing cancer treatment.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 6","pages":"323-324"},"PeriodicalIF":15.3,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140949531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David J. Benjamin, Omid Yazdanpanah, Arash Rezazadeh Kalebasty
{"title":"Overcoming barriers in cancer care for gender minorities","authors":"David J. Benjamin, Omid Yazdanpanah, Arash Rezazadeh Kalebasty","doi":"10.1038/s41585-024-00894-8","DOIUrl":"10.1038/s41585-024-00894-8","url":null,"abstract":"As the population of gender minorities grows in the setting of rising incidence of cancers globally, health-care professionals and institutions must be prepared to provide inclusive care. Individual-level training as well as institutional-level efforts on gender identity data collection and creation of inclusive clinical spaces could help mitigate health-care disparities.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 6","pages":"325-326"},"PeriodicalIF":15.3,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140915001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alessandro Larcher, Federico Belladelli, Francesco Cei, Chiara Re, Isaline Rowe, Francesco Montorsi, Umberto Capitanio, Andrea Salonia
{"title":"Centralization of care for rare genetic syndromes associated with cancer: improving outcomes and advancing research on VHL disease","authors":"Alessandro Larcher, Federico Belladelli, Francesco Cei, Chiara Re, Isaline Rowe, Francesco Montorsi, Umberto Capitanio, Andrea Salonia","doi":"10.1038/s41585-024-00874-y","DOIUrl":"10.1038/s41585-024-00874-y","url":null,"abstract":"Von Hippel–Lindau (VHL) disease is a rare genetic syndrome caused by a germline pathogenic variant in one VHL allele. Any somatic event disrupting the other allele induces VHL protein (pVHL) loss of function, ultimately leading to patients developing multiple tumours in multiple organs at multiple timepoints, and reducing life expectancy. Treatment of this complex, rare disease is often fragmented, as patients visit specialist clinicians in isolation at different medical centres. Consequently, patients can receive sub-optimal treatment that results in decreased quality of life and a poor experience of health care systems. In 2021, we established a comprehensive clinical centre at San Raffaele Hospital, Milan, devoted to VHL disease. The centre provides a structured programme for the diagnosis, surveillance and treatment of patients alongside research into VHL disease and involves a multidisciplinary team of dedicated physicians. This programme demonstrates the benefits of care centralization, including concentration of knowledge and services, synergy and multidisciplinary management, improved networking and patient resources, reducing health care costs, and fostering research and innovation. VHL disease provides an ideal model to assess the advantages of centralizing care for rare disease and represents an unparalleled opportunity to broaden our understanding of cancer biology in general. In this Perspective, Larcher et al. describe a dedicated treatment programme for Von Hippel–Lindau disease established at San Raffaele Hospital, which encompasses diagnosis, surveillance, treatment, research and outreach. The authors then discuss the benefits of care centralization for Von Hippel–Lindau disease and other rare diseases.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 9","pages":"565-571"},"PeriodicalIF":12.1,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140881286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucy Greenwald, Daniel R. Dickstein, Barbara Chubak, Deborah C. Marshall
{"title":"We all get erections — de-gendering sexual arousal dysfunction in the ICD","authors":"Lucy Greenwald, Daniel R. Dickstein, Barbara Chubak, Deborah C. Marshall","doi":"10.1038/s41585-024-00890-y","DOIUrl":"10.1038/s41585-024-00890-y","url":null,"abstract":"Definitions of sexual arousal dysfunction in the International Classification of Diseases use sex-specific binaries that omit the erectile basis of arousal in females. To provide equitable health care for all people with erectile dysfunction, these definitions must be de-gendered.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 6","pages":"319-320"},"PeriodicalIF":15.3,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Asexuality: the invisible orientation","authors":"Sarah Cosgriff, Stella Schneckenburger","doi":"10.1038/s41585-024-00891-x","DOIUrl":"10.1038/s41585-024-00891-x","url":null,"abstract":"Asexuality is often neglected in education and conversations around sexuality, making it essentially an ‘invisible orientation’. This lack of knowledge is associated with harmful misconceptions, which need challenging within the medical profession and in the general population to ensure inclusion of people who identify on the asexual spectrum.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 6","pages":"321-322"},"PeriodicalIF":15.3,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140876937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aaron Simoni, Laura Schwartz, Guillermo Yepes Junquera, Christina B. Ching, John David Spencer
{"title":"Current and emerging strategies to curb antibiotic-resistant urinary tract infections","authors":"Aaron Simoni, Laura Schwartz, Guillermo Yepes Junquera, Christina B. Ching, John David Spencer","doi":"10.1038/s41585-024-00877-9","DOIUrl":"10.1038/s41585-024-00877-9","url":null,"abstract":"Rising rates of antibiotic resistance in uropathogenic bacteria compromise patient outcomes and prolong hospital stays. Consequently, new strategies are needed to prevent and control the spread of antibiotic resistance in uropathogenic bacteria. Over the past two decades, sizeable clinical efforts and research advances have changed urinary tract infection (UTI) treatment and prevention strategies to conserve antibiotic use. The emergence of antimicrobial stewardship, policies from national societies, and the development of new antimicrobials have shaped modern UTI practices. Future UTI management practices could be driven by the evolution of antimicrobial stewardship, improved and readily available diagnostics, and an improved understanding of how the microbiome affects UTI. Forthcoming UTI treatment and prevention strategies could employ novel bactericidal compounds, combinations of new and classic antimicrobials that enhance bacterial killing, medications that prevent bacterial attachment to uroepithelial cells, repurposing drugs, and vaccines to curtail the rising rates of antibiotic resistance in uropathogenic bacteria and improve outcomes in people with UTI. Antibiotic-resistant uropathogenic bacteria are becoming increasingly prevalent. In this Review, strategies for clinicians and researchers to address this challenge are delineated, including implementation of policies, stewardship practices, and the exploration of emerging therapeutic targets aimed at mitigating antibiotic resistance.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"21 12","pages":"707-722"},"PeriodicalIF":12.1,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140845406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}