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To assess the role of influential figures within social media (SoMe) in driving future citations.

To evaluate the healthcare resource impact of radiation injury following prostate cancer treatment.

The management of long segment proximal and panureteral stenosis is complicated with few options available in the surgical armamentarium. The ileal ureteral substitution technique is well established with proven safety and efficacy. The technique can be employed to manage unilateral and bilateral ureteral disease along with simultaneous ileocystoplasty in patients with concomitant bladder dysfunction. In this paper, Soyster et al., have reported on their experience with ileal ureteral substitution in a unique cohort of patients with challenging anatomy, namely urinary diversion and bladder augmentation.

Underrepresented-in-medicine (URM) students face significant challenges in pursuing a career in Urology, including a lack of representation and financial barriers. However, targeted mentorship programs have made a profound impact on URM students entering the field of Urology. The creation of the UnderRepresented Trainees Entering Residency and Urology Unbound mentorship programs has facilitated early connections between URM students and residents and faculty, creating a supportive network that can persist throughout their training.

I appreciate the authors’ timely and influential publication identifying demographic factors associated with Urology residency attrition. As Diversity, Equity, and Inclusion (DEI) efforts continue to expand within Urology, it is imperative to assess the attrition rates of residents. It is not enough to recruit residents underrepresented in Urology, but as educators, we must ensure the resources for success are available to retain residents at risk for attrition. Although there are limitations to the study as mentioned in the manuscript, I think this data lays out what many already suspected; underrepresented minorities (URM) and women representation in Urology is not only a pipeline issue, but also a retainment issue.

The authors describe an observational study to assess surgical proficiency for vasectomy and target areas of improvement. They utilized a standardized scoring system with a mobile-based app. They broke the vasectomy procedure down to 6 steps and gave a score of 1–5 for each step.

In the realm of surgical training, reliance on operative logs or number of hours worked is simply not adequate to assess and demonstrate competency. Indeed, a recent survey of US graduates of urology residency programs showed a perceived lack of confidence in several procedures that are commonly encountered in a general urologic practice.1

To compare intra and early postoperative outcomes between pulsed-wave and continuous-wave Thulium Fiber Laser Enucleation of the Prostate (PW-ThuFLEP vs CW-ThuFLEP) for the treatment of benign prostatic hyperplasia (BPH).

Urologists today practice in a clinical environment that is awash in electronic health data. Sadly, much of these data are locked in the electronic medical record, unable to provide meaningful information for guiding patient care. Real-world evidence, such as data from the electronic medical record, can inform comparative effectiveness studies, pragmatic trials, and clinical prediction models, among other uses

To determine the prevalence of women who report avoiding exercise or stopping a workout due to lower urinary tract symptoms (LUTS) in a community population, characterize symptoms in these women, and identify clinical and demographic factors associated with exercise cessation due to LUTS.

To understand the effect of bicycle saddle shape and size on the pressure transmitted to the perineum, as prolonged perineal pressure and microtrauma amongst avid cyclists may increase the risk for complications following lower genitourinary surgery.

To project the number and proportion of women in the urology workforce using recent demographic trends and develop an app to explore updated projections using future data.

To assess the long-term incidence of treatment-related toxicities and quality of life (QOL) outcomes associated with toxicity after external beam radiotherapy (EBRT) for prostate cancer.

Per the Editor’s recommendation, we are resubmitting this revised article as a “Clinical Challenges in Urology” article. Based on the Gold Journal guidelines, no abstract is required for this article type.

Thank you for this kind editorial comment which raises so many important points. We’d like to comment on a few of these more specifically.

This is a timely and important article! We have been ignoring qualitative research for too long. While this project concentrates on semistructured qualitative interviews, other study designs such as mixed method studies may bring added value to the practical implementation of science to the care of our patients along with randomized controlled trials.1 This group is ahead of their time in adding to the quantitative outcomes spoken about for the last 50 years in the treatment of incontinence (improvement in the # of pads used per day, improvement in pad weight, change in urodynamic parameters).

To analyze our local antibiogram and antibiotic resistance patterns given concern for multidrug resistant and fungal organisms in contemporary series detailing causative organisms in Fournier’s Gangrene (FG).

To outline our experimental gonadal tissue cryopreservation (GTC) protocol that does not disrupt standard of care in medically-indicated gonadectomy for patients with differences of sex development (DSD), including highlighting the multidisciplinary collaborative protocol for when neoplasm is discovered in these cases.

Testicular torsion (TT) sometimes involves difficult decision-making for urologists/surgeons from the medicolegal standpoint. From the perspective of the patient and their parents, they would prefer that the testicles be preserved, even if reoperation (e.g., resection of a necrotic testicle) may be necessary. Hence, this study aimed to examine the preservation of grossly ischemic testicles beyond the “golden time”.

When confronting the young man with testicular torsion, urologists are often called upon to make a difficult decision; to preserve the testes following detorsion, or deem it beyond salvation. This decision point has significant ramifications from a medical and legal standpoint. It is easy to make this call if the symptoms have lasted under 4 hours and the testes turn from blue to pink upon detorsion in the operating room. But the decision point is more complicated if the testes fail to quickly reperfuse upon detorsion.