This issue contains one Review Article, nine Original Articles and three Short Communications.
Sung et al. (Seoul, Korea) reviewed robot-assisted surgery in the field of female urology. The authors introduced new techniques using robotic surgery for the management of pelvic organ prolapse and lower urinary tract fistulas. Intra-corporeal suturing and accurate pelvic dissection will be required for the laparoscopic management of these disorders. These techniques can be carried out easily and accurately in robot-assisted surgery. Robot-assisted repairs might be offered for the treatment of pelvic organ prolapse or lower urinary tract fistulas.
Lymphocele is one of the common postoperative complications of pelvic lymph node dissection (PLND). Lee et al. (Seoul, Korea) investigated the incidence of lymphocele after extraperitoneal robot-assisted radical prostatectomy (RARP) and PLND. The authors carried out magnetic resonance imaging (MRI) routinely at 3 or 4 months after RARP. A total of 483 patients underwent extraperitoneal RARP, and 200 patients (41.4%) underwent PLND. Lymphocele was detected in 41 (20.5%) patients. Seminal vesicle invasion (SVI, P = 0.015) and tumor volume (P = 0.042) were significantly different between the two groups. In the multivariate analysis, extracapsular extension (ECE; P = 0.017, odds ratio [OR] 4.231), SVI (P = 0.028, OR 2.643) and the number of positive lymph nodes (P = 0.041, OR 3.532) were independent risk factors. They concluded that ECE, SVI and the number of positive lymph nodes are independent risk factors for postoperative lymphocele after extraperitoneal RARP with PLND. From another viewpoint, lymphocele development might be a prognostic factor of prostate cancer patients who undergo RARP and PLND.
Many methods of prostate cancer screening have been evaluated to be more effective than basic screening. De Coninck et al. (Brussels, Belgium) evaluated prostate histoscanning (PHS) as a new method for screening. PHS is a computer-aided ultrasonography, and the data obtained from the transrectal ultrasound were processed. A special volumetric tool provided total prostate volume and total tumor lesion volume. The authors devised the algorithm of prostate cancer screening using PHS. A total of 94 cases were examined with PHS, and 41 cases were referred for prostate biopsy under computer-aided ultrasonographic guidance. A tumor volume increase of 1 mL estimated by PHS was associated with the probability of a positive biopsy (OR 2.9, 95% confidence interval 1.2–7.0, P = 0.02). Prostate cancer was found in 17 men (41%), and the cancer detection rate for random biopsy and directed biopsy was 13% and 58%, respectively. PHS might be helpful for the selection of patients in whom prostate biopsies are necessary.
Percutaneous nephrolithotomy (PCNL) is a popular treatment for renal calculi greater than 2 cm or staghorn calculi. Sugihara et al. (Tokyo, Japan) investigated the risk factors of severe adverse events (sAE) after PCNL from the data of 1511 cases from the Japanese nationwide database. A total of 126 (8.34%) sAE were identified. In the multivariate analysis, a linear trend between sAE and operation time was observed (OR 4.72 for 120–179 min to OR 17.95 for ≥300 min, compared with ≤119 min, P < 0.05). Female sex (OR 1.92) and emergency admission (OR 2.04) were also identified. The authors concluded that longer operation time was a salient risk factor for sAE after PCNL. It is important to inform patients of these data and also to prevent sAE. To shorten the operating time, well-planned and careful procedures are required.
There were some reports that examined prostate cancer reduction by α-1 adrenoceptor antagonist. Yamada et al. (Tokyo, Japan) investigated the effects of naftopidil, an α1-adrenoceptor antagonist, and transforming growth factor-β to reduce prostate cancer incidence. The men who continued naftopidil (n = 766) or tamsulosin (n = 1015) for 3 months or longer were evaluated. Prostate cancer incidence was significantly lower in men who received naftopidil compared with tamsulosin for 3 months or longer (14; 1.8% vs 32; 3.1%, P = 0.035), remains in multivariate analysis (P = 0.013). The authors also evaluated cell viability and apoptosis in prostate cancer cells, and the effect of naftopidil or tamsulosin. Naftopidil inhibited cell growth, induced apoptosis and blocked Smad2 phospholilation activated by transforming growth factor-β. These results suggest the effect of naftopidil as chemoprevention for prostate cancer.