Vaginal wall smooth muscle underpins pelvic support. In pelvic organ prolapse, smooth muscle cells are depleted and shift from a contractile phenotype to remodelling programmes, paralleling stress-induced switching in vascular disease. Defining trajectories and drivers could yield biomarkers and translatable, locally deliverable therapies to curb progression and recurrence.

Generative artificial intelligence (GAI) can produce high-quality lay summaries of medical literature, clinical trial information and guideline-based materials that meet recommended reading levels while preserving scientific integrity. Although important limitations remain, with appropriate safeguards, GAI has the potential to bridge longstanding gaps between certified medical knowledge and patient understanding.

Historically, the contribution of fathers to offspring health has been neglected, with the focus on mothers. However, growing evidence shows the important influence that the environmental factors the fathers experience has on sperm epigenetics and, consequently, the health of the next generation.

Artificial intelligence (AI) could transform the field of urology from student education through clinical procedures to writing and reporting. In this Focus issue on the applications of AI in urology, we present articles covering a broad range of the potential uses in the field.

Posterior nerve-sparing modifications during radical prostatectomy aim to improve preservation of the cavernous nerves and microvasculature to enhance postoperative erectile recovery. Current techniques for this are associated with varied functional outcomes and have a number of key anatomical and technical considerations.