When Nature Clinical Practice Urology launched in 2004, we could not have foreseen the ways in which our field has transformed. As we celebrate our 20th anniversary — traditionally, the ‘china’ anniversary — it gives us a chance to get out the special china tea service, sit back with a cup of tea and reflect on what this journal, and the editors who work on it, have achieved.

In November 2004, what was then Nature Publishing Group launched a group of new clinical journals. Branded Nature Clinical Practice, they aimed to provide readers with the most “reliable, relevant … informative, balanced and objective”1 content across urology, cardiolology2, gastroenterology and hepatology3 and clinical oncology4. This ethos — from the first editorial written by our launch Editor-in-Chief, Peter Scardino, continues to be the foundation of everything that we do; however, the past 20 years have seen urology completely transform as a field, in ways that we never could have imagined in 2004.

Credit: Pat Morgan/Springer Nature Limited

Over the past 20 years, this journal, which in 2009 rebranded to Nature Reviews Urology, has achieved a huge amount. We have published Consensus Statements that have pioneered clinical practice. We have become one of the most highly ranked and recognizable journals in the field. We have expanded our network throughout urology, publishing articles by established key opinion leaders in our field, early-career researchers, and even actor, writer and TV personality Stephen Fry5. As speakers, faculty members and prize-givers, we have supported conferences in UTI, sexual medicine, stones and general urology, to name just a few. We are extremely proud to be an integral part of such an exciting and varied field.

Over the past 20 years, urology has transformed as a field, both in terms of our approach to patients and to urology as a field. In 2004, the year we launched, Intuitive Surgical acquired Computer Motion and gained a monopoly on robotic surgery, following the first robotic prostatectomy, which was performed just 4 years earlier6. Since then, robotic-assisted radical prostatectomy has become the norm for men undergoing surgical treatment of prostate cancer. However, interestingly, surgical treatment has become less common. The past 20 years have seen a paradigm shift in our approach to patients, both with prostate cancer and in general, with a drive towards reducing radical treatment and supporting active surveillance of patients to maximize quality of life, including patients in shared decision-making7 and patient-reported outcome measures.

Our view of the patient as a person, rather than a disease, also reflects a general change in urology towards understanding the importance of diversity and experience for maximizing our own people working in the field. For example, since 2014, when American Urological Association Census data first became available, the proportion of female practising urologists in the USA has increased by around 50% from 7.7% to 11.8%. However, the percentage of Black US urologists has dropped from 2.5% to 1.8% — clearly we have work to do. Even so, as a journal, we have been committed to championing diversity, equity and inclusion (DEI) as essential to the growth and success of the field. We have forged links with The Society for Women in Urology, in 2023 publishing a series of Comments that focused on the specific viewpoints of women in our field (Women in Urology collection). We have published Viewpoints that focus on the experiences of Black urologists, both those who are established as pioneers in the field8 and those who were, at the time of writing, rising up through the ranks9. Our commitment to supporting our LGBTQIA+ patients and colleagues is demonstrated in our annual Pride issues, published since 2020. We were the first urology journal to present a dedicated issue around Pride and we are incredibly proud to be a platform for discussion around LGBTQIA+ medicine and DEI in general.

As we look back over our achievements10,11, we also take the opportunity to look forward towards where we see the field moving as we begin our third decade. As part of this forward-looking perspective, we are proud to present a Focus issue on the tumour immune environment in prostate cancer, a field of research that was barely considered 20 years ago.

We are so proud to have represented urology for the past 20 years and we look forward to finding out what the future holds.