Comment

Women urologists receive less compensation than male urologists. Concerted individual and institutional action is necessary to value the impact that women urologists have on patients and on the entire field.

The field of medicine has advanced towards gender equity in medical student matriculation over the past decade, but urology has lagged substantially behind other sub-specialties regarding the percentage of both women residents and women staff. This gender gap is further increased for under-represented individuals in medicine. One of the strategies to close these gaps is to create an inclusive work environment through allyship.

The number of women entering the historically male-dominated field of urology is growing over time, but women in urology are disproportionately younger than the male counterpart and face unique challenges that require intentionally directed mentorship. In this Comment, some of these issues are discussed from the perspective of both the female mentee and mentor.

Women urologists constitute an increasing proportion of the urology workforce in the United States. Considering the projected shortage of urologists over the coming decades, women urologists will have a crucial role in the delivery of urological care. Opportunities for recruitment and retention of women in the field of urology must be highlighted.

Artificial intelligence (AI) has rapidly become one of the most important and transformative technologies of our time, with applications in virtually every field and industry. Among these applications, academic writing is one of the areas that has experienced perhaps the most rapid development and uptake of AI-based tools and methodologies. We argue that use of AI-based tools for scientific writing should widely be adopted.

Sponsorship is the active and intentional use of a person’s influence or leadership status to use political and personal capital to advance a junior colleague’s career both privately and publicly. A sponsor has a seat at the decision-making table and can access the junior colleague’s work and power, and a junior colleague can capitalize on the opportunity quickly, effectively and successfully.

The COVID-19 pandemic has disrupted surgical training worldwide, and reconstructive urology training has been neglected at the expense of more urgent life-saving procedures. To help address this problem, virtual reality must become a fundamental training aid in modern reconstructive urology surgery education.

Transgender women are extensively under-represented in national cancer databases. Improved representation is urgently needed to bridge the evidence gap for this growing population and to inform prostate cancer epidemiology and professional guidelines.

Growing evidence suggests that urinary and sexual functional outcomes after radical prostatectomy for prostate cancer differ based on race, with Black men experiencing worse outcomes. Alongside efforts to improve quality and equity, incorporating patient-reported outcomes measures into patient care could improve equity in treatment outcomes for men with prostate cancer.

Despite the high prevalence of overactive bladder (OAB) syndrome, its pathophysiology remains poorly understood. Twin studies offer a unique opportunity for studying the genetics of this disorder, but trials are limited by heterogeneous patient populations. Improved understanding of genetic factors in OAB will be vital to developing targeted management.

Across health care, clinicians are increasingly using patient-reported outcome measures (PROMs) to give a voice to patients and to help standardize the assessment of patients for comparison purposes. With this increasing use, the limitations of these PROMs should not be underestimated within the diverse population that we treat.

Although gynaecology is a specialty responsible for women’s health, the field was historically male-dominated and its science remains biased towards male perceptions of women’s health. In light of the changing social climate in our society and the changing gender composition of the specialty, a number of steps can be taken to make gynaecology more women-centred.

Prostate cancer recurrence is common after radical radiotherapy and the increasing use of novel, minimally invasive salvage treatments means that accurate detection and localization of radiorecurrent disease is vital in treatment planning and delivery. PET–CT is increasingly used to detect metastatic disease; however, data regarding its value for identifying and accurately characterizing intraprostatic recurrence need improvement.

Estimation of post-surgery future glomerular filtration rate (fGFR) is crucial for the oncological management of patients with renal cell carcinoma or urinary tract urothelial carcinoma. A new and simple formula for calculating fGFR has been published and should be included in future guidelines for personalized treatment of patients to guide decisions on surgery, systemic therapies and optimal sequence of treatment.

Reliable information about sexual and reproductive health and service access during coronavirus disease 2019 (COVID-19) are essential. The International Sexual Health and Reproductive Health (I-SHARE) study is led by a multi-country consortium that adopts an open science approach to achieve this goal. Future work will be needed to assess changes in sexual and reproductive health during the lifting of COVID-19 restrictions.

Limited information exists regarding the effects of prostate cancer therapies on sexual health outcomes in sexual and gender minority patients. As clinicians, scientists and advocates, understanding these outcomes is imperative in order to enable personalized clinical decision-making and to create a more equitable health system.

Patients with prostate cancer from sexual minority groups experience considerably worse quality of life following prostate cancer treatment than heterosexual patients. Improved inclusivity as well as cultural humility training at the physician, institution and system levels are warranted to address inequalities in quality-of-life outcomes.

Incidence and mortality disparities between males and females exist in many diseases including bladder cancer, but the mechanisms remain unclear. To adequately address this issue, researchers must design experiments appropriately, appreciate that sex and gender are not synonymous concepts and understand that the role of both sex and gender in disease need to be elucidated.

Effective mentorship is important for developing trainees and faculty in urology. Crucial aspects of mentorship are necessary to create long-lasting mentorship relationships, to enhance faculty mentorship and to promote diversity and equity in urology. Innovative strategies to address challenges and opportunities are necessary to enhance the legacy of mentorship.

Recommendations for children and adolescents with single kidneys (like most survivors of Wilms tumour) for taking part in contact sporting activities are not aligned worldwide. This discrepancy can create misunderstandings regarding the perceived and real risk of abdominal impact and trauma when practising some sports.