Review Articles in 2025

This Review focuses on micro-ultrasound as a new imaging technology in prostate cancer detection, comparing micro-ultrasound performance with that of the current standard MRI. The potential of micro-ultrasound in other applications, including tumour staging and active surveillance, as well as the use of artificial intelligence to support biopsy decision-making, are also discussed, based on completed and ongoing trials.

In this Review, the authors describe the mechanisms that mediate mitochondrial sheath formation and its maintenance and function within the mature sperm. They also provide the field with a strong and up-to-date background on current data and hypotheses.

In this Review, the authors describe the pivotal role of taxanes in the treatment of prostate cancer and discuss how mechanisms that confer resistance to taxanes might be exploited to develop more effective therapeutic strategies

Atypical intraductal proliferation is a prostate biopsy finding with morphological features intermediate between high-grade prostatic intraepithelial neoplasia and intraductal carcinoma. This Review discusses histopathological features, molecular characteristics and clinical outcomes associated with AIP, and highlights the clinical implications of AIP, primarily due to the frequent association of AIP with clinically significant prostate cancer.

Persistent Müllerian duct syndrome (PMDS) is a rare difference in sex development, characterized by the presence of Müllerian duct derivatives in 46,XY individuals with male-typical development. Untreated PMDS is associated with risks of infertility and malignancy. In this Review, the authors provide an comprehensive primer on the epidemiology, pathophysiology and management of the condition, considering the need for a high index of clinical suspicion and timely intervention, raised awareness of PMDS among clinicians and multidisciplinary care to optimize outcomes for patients.

Radical cystectomy with urinary diversion is the standard of care for the treatment of localized muscle-invasive bladder cancer but is associated with severe morbidity. This Review highlights advancements in several aspects of bladder cancer care, including surgery techniques, prehabilitation measures, multimodal treatments and novel biomarkers, aimed at improving patient selection, optimizing local control and improving surgical outcomes.

In this Review, the authors describe and discuss hypoxia-associated extracellular matrix mechanisms of neutrophil recruitment, polarization and immunosuppression, how these lead to immunotherapy resistance, and potential targets to overcome ICI resistance.

In this Review, the authors describe standards informing the development and use of polygenic scores and illustrate their application to advance the clinical translation of polygenic scores to precision prostate cancer screening.

This Review focuses on the clinical effects and translational potential of digital twin applications in uro-oncology, highlights challenges and discusses future directions for implementing digital twins to achieve personalized uro-oncological diagnostics and treatment.

Priapism — an abnormal prolonged penile erection that persists in the absence of any sexual stimulation — can be subcategorized into three types: ischaemic (low-flow or veno-occlusive), non-ischaemic (high-flow or arterial) and stuttering, also known as recurrent ischaemic, priapism. The mechanisms underlying stuttering priapism are complex and involve dysregulation of the nitric oxide signalling pathway, Rho–Rho kinase pathway, adenosine, opiorphins, oxidative stress and androgens, and treatment can target these pathways, or be surgical in approach. In this Review, the authors discuss the pathology of the different types of priapism and provide an update on the different therapeutic options available.

Urinary incontinence is highly prevalent during pregnancy and in the postpartum period. This Review provides an overview of this prevalence, discussing potential mechanisms and risk factors underlying this phenomenon. The importance of preventive measures and treatment options to ameliorate the extent and the effects of urinary incontinence during this stage of life is also highlighted.

This Review discusses the potential benefits of prehabilitative interventions in patients with and survivors of testicular cancer. Although there are few studies in the field, available data suggest a benefit of prehabilitation in improving mental health and quality of life in these patients, highlighting the need for additional research in this field.

In this Review, the authors summarize how the key pathological mechanisms involved in the initiation and progression of interstitial cystitis/bladder pain syndrome can be a source of potential biomarkers to delineate the condition.

In this Review, the authors summarize the biological features of low-grade non-muscle-invasive bladder cancer, clinical risk stratification and evidence supporting treatment strategies. They also highlight contemporary developments in monitoring and therapeutic technologies.

This Review provides an overview of the main applications of single-port robotic surgery in urology, presenting emerging outcomes and discussing the transformative potential of this approach.

Despite affecting 30–50% of sexually active women, female sexual dysfunction (FSD) goes undiagnosed and untreated in many women owing to the stigma associated with sexual health, insufficient awareness and restricted access to specialized medical care. In this Review, experts in the field discuss the treatments currently available to treat FSD — including hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders — and consider the new approaches that are currently in development.

In this Review the authors explore the emerging role of HER2 in urothelial carcinoma, highlighting its biological and clinical significance, the challenges of using HER2 as a biomarker, and the variability and complexity of HER2 assessment. Evidence supporting HER2-targeted therapies and future directions for research and clinical applications are also discussed.

Sexually transmitted infections are associated with dermatological visual manifestations. This Review provides a comprehensive overview of cutaneous manifestations of sexually transmitted infections in men, with the aim of providing an up-to-date resource to help urologists and primary care physicians in the recognition and management of these visual cues.

This Review discusses different uses of digital pathology in prostate cancer, from data selection to model training and validation. Ethical and societal implications, as well as future directions in the field, are also discussed.

This Review provides a thorough comparison between uncomplicated urinary tract infections and catheter-associated urinary tract infections, highlighting that these infections are similar in terms of pathogens and sequelae, but many differences exist, for example, in pathophysiology and risk factors. The authors highlight how these differences should be considered to guide differential treatment.