The health care delivery system in the US is highly complex, regulated, and labyrinthine. Delivering quality urology care is becoming increasingly difficult. Ultimately, our patients will be the ones who suffer the adverse consequences that arise out of this environment. To ensure this does not happen, the sixth annual AUA Summit was held February 26-28, 2024, in Washington, DC, to advocate for our specialty of urology and for our patients. This meeting was attended by undergraduates, medical students, urology residents and fellows, patients, patient advocates, practicing urologists (community based, employed, academic, urban, rural), and urologic researchers. Topics for advocacy that were discussed included workforce shortages, patient access to urologic care, telehealth, decreased reimbursement, and urologic research. While advocating for policies that deliver effective, efficient, high-quality urologic care and for policies that ensure a pipeline capable of delivering enough future urologists are easily understood, advocating for policies related to increasing urologic research can be more difficult to grasp. This is because, typically, the impact of research is not felt immediately in clinical practice. However, a shortsighted view of research is detrimental to urology and our patients. Advances in diagnosis, treatment, and prevention of urologic conditions and diseases come only with research. Research achievements create value and hope that are irreplaceable.

I, as a current member and prior chair of the AUA Research Appropriations Committee (currently chaired by Joshua Stern, MD), along with other committee members (Figure), met with legislative aides of US House of Representative appropriators with a specific advocacy “ask” to introduce language into the Congressionally Directed Medical Research Program (CDMRP) appropriations bill designating an $8-million line item specifically just for bladder cancer research. CDMRP currently has line item amounts for prostate cancer ($110 million, FY23) and kidney cancer ($50 million, FY23). The growth of CDMRP funding in prostate and kidney cancers resulted in improvements in diagnosis and care of patients afflicted with these cancers. It is expected that over time, a similar impact will occur in bladder cancer if this line item ask is successful.

To further amplify this specific ask, the AUA Summit included a panel session, which I moderated, discussing the impact of research in bladder cancer. Dr Daniel Petrylak, professor of medicine and urology at Yale University and division chief of genitourinary cancer at Smilow Cancer Center, presented a talk entitled “Bladder Cancer Treatment: An Evolution in Progress.” Dr Petrylak showed that results from the randomized controlled trial in advanced bladder cancer demonstrated that enfortumab vedotin and pembrolizumab, compared to standard platinum chemotherapy, doubled median overall survival to 32 months from 16 months.¹ This result gives new hope to patients with metastatic bladder cancer. Carlos Glender, a US Navy veteran and a bladder cancer survivor, spoke about his experience with bladder cancer and the outstanding care he received at Atrium Health Levine Cancer in Charlotte, North Carolina. This panel session was also intended to motivate and exhort those attending the AUA Summit to communicate with their congressional representatives to support the $8-million line item for bladder cancer research in the CDMRP appropriations bill.

Urology is a vital specialty that has improved and saved the lives of many individuals. We must continue to advocate with one voice to continue to help our patients in a time of complex, regulated, and labyrinthine health care delivery. You can help by attending future AUA Summit meetings and donating to the AUA Political Action Committee at https://myauapac.org.