Purpose of reviewFemale sexual function after radical cystectomy is a crucial, but historically overlooked component of bladder cancer survivorship. This review focuses on recent studies, which have investigated pelvic health and sexual function after radical cystectomy. We discuss modifiable factors, which may contribute to decreased sexual function after radical cystectomy and techniques, which may lead to improved outcomes.Recent findingsSexual function is important to women and there is a significant desire (and unmet need) for more perioperative counseling and discussion regarding sexual function changes and quality of life impacts. Sexual function may be altered due to a combination of hormonal changes from ovarian removal, anatomic changes from vaginal alteration, and sensation changes due to damage to the neurovascular bundle. Techniques to preserve these structures have been developed.SummarySexual function is an important component of survivorship and increasing attention is being focused on this area. Long term studies with objective measures are needed for to compare various techniques and ensure oncologic safety. Ovarian preservation, anterior vaginal wall preservation, and vaginal estrogen replacement should be carefully considered for most patients.

Despite the increasing number of women in surgical subspecialties, barriers to career advancement and salary increases persist, previously described as the "sticky floor, glass ceiling" phenomenon. 1 A recent study found that female academic urologists published fewer papers than their male counterparts, were less likely to be promoted and had lower h-indices when compared to men. 2 Prior work has suggested that the historically male-dominant culture of surgery influences a woman's experience in residency training and throughout her career, with studies showing that men may receive more operative autonomy than women during their training and that trainees received different types of feedback based on their gender. 3,4 It has also been shown that women have significantly lower salary expectations and are less likely to believe that they have the tools to successfully negotiate upon residency completion. 5 Given the potential influence of gender on a variety of aspects of residency training, we explored how current urology residents perceive its impact. No a priori hypothesis was specified. MethodsAfter Institutional Review Board approval, a 10-item questionnaire was sent by the Society of Academic Urologists to