Pub Date : 2025-08-20DOI: 10.1038/s41585-025-01076-w
Yacov Reisman, Alexandra Dubinskaya, Anna Padoa
Female sexual dysfunction (FSD) is common and affects women of all ages. Between 30% and 50% of sexually active women will encounter some type of FSD at some point in their life, highlighting its importance as a public health issue. 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. Over the past few decades, considerable progress in understanding FSD has resulted in the development of pharmacological therapies; the treatment of FSD should be evaluated through a biopsychosocial approach to determine whether to use medication, therapy or a mix of both methods. A number of non-hormonal pharmacological treatments for FSD are available, specifically to treat hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders. Further work towards the development of future therapies will help to better support women with FSD. 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.
{"title":"Current and future pharmacotherapy for female sexual dysfunction","authors":"Yacov Reisman, Alexandra Dubinskaya, Anna Padoa","doi":"10.1038/s41585-025-01076-w","DOIUrl":"10.1038/s41585-025-01076-w","url":null,"abstract":"Female sexual dysfunction (FSD) is common and affects women of all ages. Between 30% and 50% of sexually active women will encounter some type of FSD at some point in their life, highlighting its importance as a public health issue. 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. Over the past few decades, considerable progress in understanding FSD has resulted in the development of pharmacological therapies; the treatment of FSD should be evaluated through a biopsychosocial approach to determine whether to use medication, therapy or a mix of both methods. A number of non-hormonal pharmacological treatments for FSD are available, specifically to treat hypoactive sexual desire disorder, female sexual arousal disorder, female orgasmic disorder and female genitopelvic pain disorders. Further work towards the development of future therapies will help to better support women with FSD. 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.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 2","pages":"133-147"},"PeriodicalIF":14.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898220","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}
Pub Date : 2025-08-20DOI: 10.1038/s41585-025-01084-w
Cameron J. Britton, Brian D. Cortese, Ruchika Talwar
In April 2025, the US executive administration announced universal 10% tariffs on all imported products, in addition to reciprocal tariffs for select foreign nations. As trade negotiations evolve, it is essential to recognize and evaluate the profound implications these economic policies hold for healthcare systems.
{"title":"Economic impact of tariffs on healthcare costs in urology","authors":"Cameron J. Britton, Brian D. Cortese, Ruchika Talwar","doi":"10.1038/s41585-025-01084-w","DOIUrl":"https://doi.org/10.1038/s41585-025-01084-w","url":null,"abstract":"In April 2025, the US executive administration announced universal 10% tariffs on all imported products, in addition to reciprocal tariffs for select foreign nations. As trade negotiations evolve, it is essential to recognize and evaluate the profound implications these economic policies hold for healthcare systems.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"8 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144898221","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}
Pub Date : 2025-08-19DOI: 10.1038/s41585-025-01077-9
Thorsten H. Ecke, Sarah Collen, Alex Filicevas, Theodoros Yfantis, Florence Le Calvez-Kelm, Bente Thoft Jensen, Hein van Poppel
Cancer is a crucial health priority of the current European Commission and a pillar of a strong European Health Union. However, policy measures targeting cancer in the EU do not approach all types of cancer equally. Bladder cancer is the fifth most common cancer in Europe. Although bladder cancer is associated with one of the highest lifetime costs of any cancer, research funding is among the lowest. This imbalance has led to an alarming stagnation in the availability of diagnostic tools, which negatively affected the prognosis and treatment options for bladder cancer, and resulted in complex pathways for patients. The lack of bladder-cancer awareness drastically hinders early detection. Furthermore, insufficient understanding of gender differences in bladder-cancer symptoms exacerbates the gender gap, leading to worse outcomes for women. After the European elections in 2024 and the learnings from Europe’s Beating Cancer Plan, additional effort is needed to inform the policymakers in Brussels and the Member-State capitals to consider an EU agenda with ambitious policy actions targeting neglected cancers, such as bladder cancer, and close the cancer-care gap by supporting awareness and education and by ensuring access to high-quality diagnostic tools, care and treatment. In this Expert Recommendation, a group of clinicians and scientists with high expertise in crucial areas of bladder cancer joined forces, together with members from patient groups and nurses’ associations, to write ten recommendations addressed to politicians and health care professionals in the EU to increase awareness of bladder cancer and improve targeted policy actions for this neglected cancer.
{"title":"Urinary bladder cancer needs more attention — recommendations for health care professionals and politicians in the European Union","authors":"Thorsten H. Ecke, Sarah Collen, Alex Filicevas, Theodoros Yfantis, Florence Le Calvez-Kelm, Bente Thoft Jensen, Hein van Poppel","doi":"10.1038/s41585-025-01077-9","DOIUrl":"10.1038/s41585-025-01077-9","url":null,"abstract":"Cancer is a crucial health priority of the current European Commission and a pillar of a strong European Health Union. However, policy measures targeting cancer in the EU do not approach all types of cancer equally. Bladder cancer is the fifth most common cancer in Europe. Although bladder cancer is associated with one of the highest lifetime costs of any cancer, research funding is among the lowest. This imbalance has led to an alarming stagnation in the availability of diagnostic tools, which negatively affected the prognosis and treatment options for bladder cancer, and resulted in complex pathways for patients. The lack of bladder-cancer awareness drastically hinders early detection. Furthermore, insufficient understanding of gender differences in bladder-cancer symptoms exacerbates the gender gap, leading to worse outcomes for women. After the European elections in 2024 and the learnings from Europe’s Beating Cancer Plan, additional effort is needed to inform the policymakers in Brussels and the Member-State capitals to consider an EU agenda with ambitious policy actions targeting neglected cancers, such as bladder cancer, and close the cancer-care gap by supporting awareness and education and by ensuring access to high-quality diagnostic tools, care and treatment. In this Expert Recommendation, a group of clinicians and scientists with high expertise in crucial areas of bladder cancer joined forces, together with members from patient groups and nurses’ associations, to write ten recommendations addressed to politicians and health care professionals in the EU to increase awareness of bladder cancer and improve targeted policy actions for this neglected cancer.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 1","pages":"40-49"},"PeriodicalIF":14.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883309","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}
Pub Date : 2025-08-19DOI: 10.1038/s41585-025-01082-y
Andrew L Hong, Elizabeth A Mullen
{"title":"Finding a brush when you expect a broom: a novel model of paediatric Wilms tumour evolution.","authors":"Andrew L Hong, Elizabeth A Mullen","doi":"10.1038/s41585-025-01082-y","DOIUrl":"10.1038/s41585-025-01082-y","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":" ","pages":""},"PeriodicalIF":14.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883308","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}
Pub Date : 2025-08-15DOI: 10.1038/s41585-025-01075-x
Daniele Raggi, Emanuele Crupi, Filippo Pederzoli, Alberto Martini, Alberto Briganti, Omar Alhalabi, Peter H. O’Donnell, Jeffrey Ross, Shilpa Gupta, Ashish M. Kamat, Bishoy M. Faltas, Peter C. Black, Phillip E. Spiess, Petros Grivas, Jianjun Gao, Andrea B. Apolo, Robert A. Huddart, Andrea Necchi, Matthew D. Galsky
Human epidermal growth factor receptor 2 (HER2) has emerged as a crucial biomarker across various cancers, shaping therapeutic strategies and prognostic evaluations. In urothelial carcinoma, HER2 positivity rates can reach up to 68% when HER2-low tumours (immunohistochemistry 1+) are included in the analysis. HER2 overexpression and ERBB2 genomic alterations have been linked to advanced disease stages and poor outcomes in urothelial carcinoma. Emerging evidence suggests that HER2-low tumours might be a distinct and actionable subgroup. Accurate and consistent assessment of HER2 status is increasingly vital to identify patients likely to benefit from HER2-targeted therapies, raising interest in refining thresholds for HER2 expression, aiming to predict treatment response. HER2 heterogeneity across stages and histological subtypes complicates its evaluation, with definitions of HER2 positivity differing between clinical trials and treatments. In urothelial carcinoma, HER2-targeted therapies, such as tyrosine kinase inhibitors, monoclonal antibodies and antibody–drug conjugate (ADCs) have been explored. Unlike tyrosine kinase inhibitors and monoclonal antibodies, which act through HER2-related pathways, ADCs use HER2 as a target but achieve efficacy through additional mechanisms, enabling their activity even at low HER2 expression levels. Trastuzumab deruxtecan, a novel anti-HER2 ADC, has received FDA tumour-agnostic approval for unresectable or metastatic HER2+ solid tumours, including urothelial carcinoma, after prior therapies. Interactions between HER2 protein and putative biomarkers such as EGFR, NECTIN4, PDL1 and FGFR3 genomic alterations might influence therapeutic outcomes, offering opportunities for improved patient selection and innovative combination strategies. 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.
{"title":"HER2 and urothelial carcinoma: current understanding and future directions","authors":"Daniele Raggi, Emanuele Crupi, Filippo Pederzoli, Alberto Martini, Alberto Briganti, Omar Alhalabi, Peter H. O’Donnell, Jeffrey Ross, Shilpa Gupta, Ashish M. Kamat, Bishoy M. Faltas, Peter C. Black, Phillip E. Spiess, Petros Grivas, Jianjun Gao, Andrea B. Apolo, Robert A. Huddart, Andrea Necchi, Matthew D. Galsky","doi":"10.1038/s41585-025-01075-x","DOIUrl":"10.1038/s41585-025-01075-x","url":null,"abstract":"Human epidermal growth factor receptor 2 (HER2) has emerged as a crucial biomarker across various cancers, shaping therapeutic strategies and prognostic evaluations. In urothelial carcinoma, HER2 positivity rates can reach up to 68% when HER2-low tumours (immunohistochemistry 1+) are included in the analysis. HER2 overexpression and ERBB2 genomic alterations have been linked to advanced disease stages and poor outcomes in urothelial carcinoma. Emerging evidence suggests that HER2-low tumours might be a distinct and actionable subgroup. Accurate and consistent assessment of HER2 status is increasingly vital to identify patients likely to benefit from HER2-targeted therapies, raising interest in refining thresholds for HER2 expression, aiming to predict treatment response. HER2 heterogeneity across stages and histological subtypes complicates its evaluation, with definitions of HER2 positivity differing between clinical trials and treatments. In urothelial carcinoma, HER2-targeted therapies, such as tyrosine kinase inhibitors, monoclonal antibodies and antibody–drug conjugate (ADCs) have been explored. Unlike tyrosine kinase inhibitors and monoclonal antibodies, which act through HER2-related pathways, ADCs use HER2 as a target but achieve efficacy through additional mechanisms, enabling their activity even at low HER2 expression levels. Trastuzumab deruxtecan, a novel anti-HER2 ADC, has received FDA tumour-agnostic approval for unresectable or metastatic HER2+ solid tumours, including urothelial carcinoma, after prior therapies. Interactions between HER2 protein and putative biomarkers such as EGFR, NECTIN4, PDL1 and FGFR3 genomic alterations might influence therapeutic outcomes, offering opportunities for improved patient selection and innovative combination strategies. 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.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 2","pages":"110-132"},"PeriodicalIF":14.6,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851323","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}
Pub Date : 2025-08-13DOI: 10.1038/s41585-025-01071-1
Marcelo Mass Lindenbaum, Daniela Calderón, Vivek Aslot, Bernardita Ljubetic, Daria Harlamova, Raevti Bole, Petar Bajic, Jorge Navarrete
Considering the increasing prevalence of sexually transmitted infections, accurate diagnosis and management based on the diverse dermatological presentations of sexually transmitted infections are crucial. A strong visual diagnostic skill set guides clinicians towards prompt recognition, directs appropriate diagnostic testing and enables timely initiation of treatment. This procedure in turn helps to interrupt infection transmission and mitigate long-term complications. Thus, incorporating visual learning and a dermatological perspective into urology training is essential, empowering urologists to make a difference in improving sexual health outcomes and supporting public health efforts. 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.
{"title":"Visual clues — dermatological manifestations of sexually transmitted infections in men","authors":"Marcelo Mass Lindenbaum, Daniela Calderón, Vivek Aslot, Bernardita Ljubetic, Daria Harlamova, Raevti Bole, Petar Bajic, Jorge Navarrete","doi":"10.1038/s41585-025-01071-1","DOIUrl":"10.1038/s41585-025-01071-1","url":null,"abstract":"Considering the increasing prevalence of sexually transmitted infections, accurate diagnosis and management based on the diverse dermatological presentations of sexually transmitted infections are crucial. A strong visual diagnostic skill set guides clinicians towards prompt recognition, directs appropriate diagnostic testing and enables timely initiation of treatment. This procedure in turn helps to interrupt infection transmission and mitigate long-term complications. Thus, incorporating visual learning and a dermatological perspective into urology training is essential, empowering urologists to make a difference in improving sexual health outcomes and supporting public health efforts. 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.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 2","pages":"89-109"},"PeriodicalIF":14.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825472","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}
Pub Date : 2025-08-12DOI: 10.1038/s41585-025-01080-0
Vincenza Conteduca, Himisha Beltran
Advances in molecular profiling technologies that capture both genotype and phenotype, coupled with an improved understanding of the biological mechanisms underlying prostate cancer progression, set new molecular biomarkers for advancement into the clinic to improve prognostication, therapy selection and disease monitoring for patients with prostate cancer.
{"title":"State of the art — biomarkers in advanced prostate cancer","authors":"Vincenza Conteduca, Himisha Beltran","doi":"10.1038/s41585-025-01080-0","DOIUrl":"https://doi.org/10.1038/s41585-025-01080-0","url":null,"abstract":"Advances in molecular profiling technologies that capture both genotype and phenotype, coupled with an improved understanding of the biological mechanisms underlying prostate cancer progression, set new molecular biomarkers for advancement into the clinic to improve prognostication, therapy selection and disease monitoring for patients with prostate cancer.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"67 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819221","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}
Pub Date : 2025-08-04DOI: 10.1038/s41585-025-01070-2
Heyuan Michael Ni, Ramez Kouzy, Ali Sabbagh, Michael K. Rooney, Jean Feng, Simon P. Castillo, Sherif M. Gadoue, Zakaria El Kouzi, Karen Hoffman, Yinyin Yuan, Anant Madabhushi, Osama Mohamad
Prostate cancer is among the most common cancers worldwide, with ~1.5 million new diagnoses globally every year. The sheer mass of data becoming available on prostate cancer, as well as other types of cancer, is increasing exponentially. The growth of digital pathology has particularly sparked interest in developing artificial intelligence (AI) approaches to data synthesis to predict cancer grade and outcomes in men with prostate cancer. Progress has been made in this field, particularly in applications for diagnosis, prognosis and inferring molecular alterations, but several challenges remain. Variability in tissue processing and scanning contribute to dataset heterogeneity. The absence of well-annotated, multi-institutional databases hinders AI model development and generalization of model performances across clinical settings. Regulatory frameworks for AI-driven diagnostics remain nascent. Moreover, bias in training datasets skewing against under-represented demographic groups poses a fundamental challenge to developing equitable models. By mapping contemporary evidence around each of these hurdles and identifying tangible interventions, we can advance AI-augmented digital pathology towards reliable and generalizable tools to improve prostate cancer care. 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.
{"title":"The state of the art in artificial intelligence and digital pathology in prostate cancer","authors":"Heyuan Michael Ni, Ramez Kouzy, Ali Sabbagh, Michael K. Rooney, Jean Feng, Simon P. Castillo, Sherif M. Gadoue, Zakaria El Kouzi, Karen Hoffman, Yinyin Yuan, Anant Madabhushi, Osama Mohamad","doi":"10.1038/s41585-025-01070-2","DOIUrl":"10.1038/s41585-025-01070-2","url":null,"abstract":"Prostate cancer is among the most common cancers worldwide, with ~1.5 million new diagnoses globally every year. The sheer mass of data becoming available on prostate cancer, as well as other types of cancer, is increasing exponentially. The growth of digital pathology has particularly sparked interest in developing artificial intelligence (AI) approaches to data synthesis to predict cancer grade and outcomes in men with prostate cancer. Progress has been made in this field, particularly in applications for diagnosis, prognosis and inferring molecular alterations, but several challenges remain. Variability in tissue processing and scanning contribute to dataset heterogeneity. The absence of well-annotated, multi-institutional databases hinders AI model development and generalization of model performances across clinical settings. Regulatory frameworks for AI-driven diagnostics remain nascent. Moreover, bias in training datasets skewing against under-represented demographic groups poses a fundamental challenge to developing equitable models. By mapping contemporary evidence around each of these hurdles and identifying tangible interventions, we can advance AI-augmented digital pathology towards reliable and generalizable tools to improve prostate cancer care. 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.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"23 1","pages":"13-28"},"PeriodicalIF":14.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777828","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}
Pub Date : 2025-08-01DOI: 10.1038/s41585-025-01065-z
Jonathan J. Molina, Ana L. Flores-Mireles
Urinary tract infections are one of the most common infections, accounting for ~400 million diagnoses per year worldwide. Uncomplicated urinary tract infections (uUTIs) occur in healthy individuals with no structural or functional abnormalities of the urinary system and primarily affect women. Catheter-associated urinary tract infections (CAUTIs) are a type of complicated UTI affecting patients who have a urinary catheter in place, often hospitalized patients or patients with conditions that prevent them from urinating naturally. Both infections share common symptoms, diagnostics and treatment options but also differ greatly in pathophysiology, aetiology, risk factors and comorbidities. These differences could explain why antibiotic treatments — which generally lead to positive outcomes in patients with uUTIs — often fail in patients with CAUTIs. Understanding these differences could guide evidence-based insights into why treatments for CAUTIs should be different from those for uUTIs, specifically, by modifying catheters, which initiate the damage-induced segue for UTIs. 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.
{"title":"CAUTIon — not all UTIs are the same","authors":"Jonathan J. Molina, Ana L. Flores-Mireles","doi":"10.1038/s41585-025-01065-z","DOIUrl":"10.1038/s41585-025-01065-z","url":null,"abstract":"Urinary tract infections are one of the most common infections, accounting for ~400 million diagnoses per year worldwide. Uncomplicated urinary tract infections (uUTIs) occur in healthy individuals with no structural or functional abnormalities of the urinary system and primarily affect women. Catheter-associated urinary tract infections (CAUTIs) are a type of complicated UTI affecting patients who have a urinary catheter in place, often hospitalized patients or patients with conditions that prevent them from urinating naturally. Both infections share common symptoms, diagnostics and treatment options but also differ greatly in pathophysiology, aetiology, risk factors and comorbidities. These differences could explain why antibiotic treatments — which generally lead to positive outcomes in patients with uUTIs — often fail in patients with CAUTIs. Understanding these differences could guide evidence-based insights into why treatments for CAUTIs should be different from those for uUTIs, specifically, by modifying catheters, which initiate the damage-induced segue for UTIs. 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.","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"22 12","pages":"799-814"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756442","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}
Pub Date : 2025-07-31DOI: 10.1038/s41585-025-01074-y
Maria I Carlo,A Ari Hakimi
{"title":"Dissecting the molecular landscape of fumarate hydratase-deficient RCC: towards precision oncology.","authors":"Maria I Carlo,A Ari Hakimi","doi":"10.1038/s41585-025-01074-y","DOIUrl":"https://doi.org/10.1038/s41585-025-01074-y","url":null,"abstract":"","PeriodicalId":19088,"journal":{"name":"Nature Reviews Urology","volume":"10 1","pages":""},"PeriodicalIF":15.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756155","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}
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