For the past 20 years, Nature Reviews Urology has evolved alongside the field, reflecting a shift towards basic research as a tool to inform clinical practice. From the latest developments in urology to the advent of telehealth, the journal has remained committed to delivering rigorous and unbiased science, accessible to a global audience.

Nature Reviews Urology was launched in 2004 with the aim of making a difference in the field. After 20 years and the publication of almost 800 Reviews, we are proud to say we worked hard towards that aim, and in the past 20 years, the journal content has constantly evolved to match shifts of focus in the urology field.

To get a sense of how much the field has changed in the past 20 years, consider that many targeted therapies (sunitinib, bevacizumab and erdafitinib), immunotherapies (atezolizumab and pembrolizumab) and hormonal therapies (abiraterone and enzalutamide) that are now standard of care for patients with urological cancers were either non-existent or unapproved when the journal was launched. With growing therapeutic options, patient selection and personalized medicine became pressing challenges in the field. Thus, research in the past two decades has been focused on the identification of diagnostic, prognostic and monitoring biomarkers. Reflecting this trend, our journal content has increasingly focused on biomarkers in uro-oncology, particularly those obtained through non-invasive liquid biopsies1, which offer alternative sources of biomarkers, such as urine and blood2,3. Our Reviews in this field collectively emphasized the importance of translating this huge body of knowledge into clinical application through validation, standardization and rigorous clinical trials, but also highlighted the crucial role of basic science in guiding clinical research. The past 20 years were characterized by a growing recognition that advancing cancer therapies necessitates a fundamental understanding of the mechanisms driving tumour growth and development. This basic science progress has also shaped the content of a clinical journal such as Nature Reviews Urology, leading to an increase in the publication of articles on disease mechanisms, pathways and preclinical models in urology4,5,6. This and other fields within urology have experienced a continuous and substantial advancement over the years, allowing for some projection of future trends. Conversely, other fields have taken an unexpected turn in the past 4–5 years.

Credit: Pat Morgan/Springer Nature Limited

In our 15-year anniversary Collection, Chad Ellimoottil from the University of Michigan tried to predict how urology practice would have changed in the subsequent 15 years7. He predicted that in 2035, patient encounters with the urologist would extend beyond the office to include video conferences. This prediction became a reality surprisingly quickly, drastically accelerated by the COVID-19 pandemic, and 5 years after that article, the telemedicine debate remains as heated as ever. Similarly, he envisioned a future where collaboration and information retrieval for urologists would evolve. These predictions have been surpassed by reality, as preliminary experiences described the possibility for clinicians and surgeons to discuss, collaborate and stay informed in a metaverse environment, which is a growing area to monitor in the near future8.

Something that has not changed over time is our effort and dedication to make our articles accessible to a wide readership as part of our commitment towards inclusion and diversity. Every day, we fulfil this mission by improving manuscript clarity through comprehensive editing and by using plain English to make our articles globally accessible9.

Thus, whatever the next advances in urology will be, we at Nature Reviews Urology are eager to be a platform to collate and divulgate science with our approach: rigorous, unbiased and, most of all, accessible to everyone.