It is my great pleasure to edit and publish the special issue of International Journal of Urology, entitled “Recent topics relevant to radical prostatectomy”. As you know, the concept of radical prostatectomy has drastically changed in recent years. For example, a detailed characterization of the pelvic anatomy has made a substantial contribution for refining the surgical technique of this surgery. In addition, the introduction of a robot-assisted system in the field of this surgery resulted in the paradigm shift of the procedure of radical prostatectomy; that is, the majority of radical prostatectomies in North America are currently carried out using robot-assisted techniques, and the proportion of robot-assisted radical prostatectomy in Japan is also markedly increasing. Considering these circumstances, I believe that this timely-edited special issue will be of interest to the readers of International Journal of Urology.
This issue consists of five Invited Review Articles, one Review Article, four Original Articles and one Short Communication. These studies describe the hot topics associated with radical prostatectomy, and the content of this issue might help provide useful information to resolve and overcome several problems regarding radical prostatectomy.
This issue starts with a review focusing on the recent progress in the knowledge of pelvic anatomy by Hinata et al. (Yonago, Japan). They precisely described the updated findings on anatomical landmarks related to radical prostatectomy, including the carvenous nerve, prostatic fascia, Denonvillers' fascia, endopelvic fascia and apex of the prostate. Subsequently, the current status of robot-assisted radical prostatectomy was comparatively described with those of other surgical approaches by Lim et al. (Seoul, Korea). It was emphasized in this review that robot-assisted radical prostatectomy offers at least equivalent oncological and functional outcomes when compared with open and laparoscopic prostatectomies.
Four other excellent reviews are included in this issue. Kaiho et al. (Sendai, Japan) provided detailed information on the significance of phosphodiesterase type 5 inhibitors in penile rehabilitation following radical prostatectomy. Ischia and Gleave (Vancouver, Canada) reported the role of surgery for men with high-risk prostate cancer based on the advantageous features of radical prostatectomy for this type of cohort, especially favorable local control of the primary tumor without an increase in morbidity. Miyake and Fujisawa (Kobe, Japan) described the current status of prognostic prediction following radical prostatectomy. They emphasized the limitations of available systems and the development of new tools incorporating conventional, as well as molecular, biomarkers. Moran et al. (Dublin, Ireland) carried out a meta-analysis for comparing robot-assisted radical prostatectomy with open and laparoscopic approaches, and found some differences between robot-assisted and open approaches in favor of the robotic surgery.
Consistent with the Review Articles, four Original Articles and one Short Communication are provided in this issue. Sato et al. (Sapporo, Japan) reported the importance of partners' cooperative attitude in the maintenance of patients' sexual desire and motivation after radical prostatectomy. Kaneko et al. (Tokyo, Japan) identified high body mass index and prostate weight as independent predictors of prolonged total operative time in laparoscopic radical prostatectomy. Okamura et al. (Nagoya, Japan) carried out a multi-institutional study and showed that when standardized goals in perioperative care are recommended, both setting and practice of perioperative care in men undergoing radical prostatectomy were significantly improved. May et al. (Munich, Germany) demonstrated a promising role of Schwann cell-mediated delivery of glial cell line-derived neurotrophic factor for the treatment of erectile dysfunction after cavernous nerve injury, such as that during radical prostatectomy. Sugihara et al. (Iwata, Japan) carried out a comparative evaluation for perioperative outcomes and costs between open and laparoscopic radical prostatectomies, and found several benefits of the laparoscopic approach over open surgery.