IJU this issue

Abstract

This issue of International Journal of Urology contains one Review Article, 11 Original Articles, two Urological Notes and 13 Editorial Comments. Taguchi et al (Tokyo, Japan) reviewed the evidence on the prognostic significance of tertiary Gleason pattern (TGP), and discussed how to deal with it in the context of the contemporary Gleason score and Gleason grade grouping. According to the 2019 International Society of Urological Pathology, a provisional definition of TGP is “<5% Gleason pattern 4 or 5 in radical prostatectomy specimens.” Although no objective and scientific data supporting this cut-off value have been reported, TGP should be routinely reported in radical prostatectomy specimens and further studies are required to assess the associations of TGP with prognostic significances. In the Original Articles, Kimura et al. (Tottori, Japan) reported the impact of penile rehabilitation on the recovery of erectile function after robot-assisted radical prostatectomy. Erectile dysfunction still remains an important complication after robot-assisted radical prostatectomy despite the preservation of neurovascular bundles with nerve-sparing (NS) surgery. This study presents novel findings regarding postoperative penile rehabilitation with phosphodiesterase-5 inhibitor, not only in cases of bilateral NS and/or unilateral NS, but also in other types of NS, such as partial NS or non-NS. Zhang et al. (Beijing, China) evaluated the outcomes and the learning curves of flexible ureteroscopy (FURS) and mini-percutaneous nephrolithotomy for pediatric kidney stones larger than 2 cm. FURS has already been shown to be a safe and feasible procedure alternative to percutaneous nephrolithotomy for children with upper urinary stones with a systematic review and meta-analysis (Urolithiasis 2019; 47: 189–99); however, this study showed an interesting finding, that a minimum of 20 cases of mini-percutaneous nephrolithotomy and 50 cases of FURS are necessary to achieve a high stone-free rate for pediatric kidney stones larger than 2 cm. Okada et al. (Chiba, Japan) reported the differences in the handling of forceps between the one-surgeon and two-surgeon techniques using an off-site simulator model. Nearly half of endourologists used only the dusting technique in their FURS practice, according to a recent worldwide survey of FURS practice from the European Association of Urology sections of young academic urologists (aged <40 years) and uro-technology groups (Cent. Eur. J. Urol. 2019; 72: 393–7). The European Association of Urology Guidelines on Urolithiasis has mentioned that “dust and go” strategies should be limited to the treatment of large (renal) stones and stones that can be extracted by endoscopic forceps or baskets. Therefore, the establishment of standards, safety requirements and acceptable procedures for basketing is essential. A large-scale study is required to confirm its usefulness as a new standard modality of stone retrieval in FURS. Shobeirian et al. (Rasht, Iran) evaluated the efficacy of intraprostatic injection of prophylactic antibiotics for the prevention of infections after transrectal ultrasonography-guided prostate biopsy. This unique concept of injecting antibiotics directly into the prostate was proposed in both animal and human studies, and its efficacy in the treatment of drug-resistant chronic prostatitis has already been reported. It will be necessary to carry out a randomized controlled trial. In the Urological Notes, Tully et al. (Boston, USA) analyzed bladder cancer incidence trends using the Surveillance, Epidemiology and End Results database, with a focus on distant stage among young individuals. They discussed possible explanations for the rising incidence of distant bladder cancer among young individuals. Unfortunately, the limited space does not allow me to introduce all the articles. However, all the papers are very interesting and informative. Please enjoy this issue of International Journal of Urology. None declared.