This Issue 32‐4

This issue contains two review articles, thirteen original articles, and three urological notes. Partial nephrectomy (PN) has been used clinically for over a century. Early experience with PN was associated with intraoperative and delayed hemorrhage, urinary fistula, sepsis, and mortality. Mapping of segmental renal arterial supply, the introduction of computed tomography for both early tumor detection and preoperative planning, and improvements in nephron-sparing surgery techniques saw open PN increasingly performed in the late 20th century. Homewood et al. (Melbourne, Australia) review the history of partial nephrectomy and the early techniques used to close the parenchymal defect, highlighting their advantages and disadvantages. This article further investigates the principles and mechanisms of the techniques which are conventional techniques of closing renal parenchyma, knotless sliding clip renorrhaphy, continuous versus interrupted suture, single versus double layer closure, hilar renorrhaphy, off-clamp vs. on-clamp renorrhaphy, the role of non-renorrhaphy techniques, and hemostatic agents. The authors have concluded that, with the ever-growing application of robotically assisted surgery into other operations and indeed specialties, it is worth considering how the lessons learnt from improving renorrhaphy in minimally invasive surgery may be applied more broadly. Minimally invasive surgery (MIS), such as laparoscopy, has been a cornerstone in reducing surgical morbidity and promoting faster recovery in pediatric patients. The advent of robotic-assisted surgery (RAS) has further expanded the potential of MIS. Robotic systems provide enhanced dexterity, precision, and visualization, which are particularly beneficial in the delicate and complex surgical procedures required for pediatric genitourinary tumors. Yadav et al. (Lucknow, India) have performed a systematic review to explore the current role of RAS in the treatment of pediatric genitourinary tumors. The authors have concluded that continued technological advancements and collaborative efforts among diverse experts have paved the way for further exploration and refinement in the emerging field of robotic-assisted pediatric genitourinary tumors. Urinary incontinence after radical prostatectomy significantly affects patients' quality of life, and robot-assisted laparoscopic radical prostatectomy (RARP) shows better recovery of urinary continence compared to open radical prostatectomy and laparoscopic radical prostatectomy. Funajima et al. (Yamagata, Japan) retrospectively evaluated the factors influencing urinary continence recovery after RARP with a particular focus on the impact of anterior reconstruction in patients with posterior reconstruction. They found that anterior pelvic floor reconstruction improved the continence rate only at 1 month after RARP. The authors have concluded that anterior pelvic floor reconstruction contributes to early urinary continence recovery after RARP compared to the only posterior reconstruction technique. The effectiveness of docetaxel in addition to next-generation androgen receptor-axis-targeted therapies (ARAT) and androgen deprivation therapy (ADT) for metastatic hormone-sensitive prostate cancer (mHSPC) remains unclear. Chen et al. (Tokyo, Japan) evaluated the results regarding the effect of adding docetaxel to ARAT and ADT treatment for mHSPC, based on the reconstructed individual patient data from clinical trials. This study suggested that even in high-volume disease cases, patients with mHSPC do not appear to derive significant additional benefit from the addition of docetaxel to ARAT and ADT. The authors have concluded that further prospective studies are required to provide more accurate and evidential results for personalized treatment recommendations. The choice between ureteroscopy (URS) and shock wave lithotripsy (SWL) for ureteral stones remains debated due to differing stone-free statuses. Nozumi et al. (Funabashi, Japan) performed the retrospective study to evaluate the efficacy of SWL for ureteral stones performed exclusively by SWL experts and to identify predictors of stone-free status (SFS) following SWL, with particular attention to the impact of stones remaining in the same location (SSL). They have found that SWL remains a mainstay of treatment options for ureteral stones in terms of safety and effectiveness, and that SSL2 (stone at the same location ≥ 2 months) and mean stone density (MSD) are strong predictors of the SFS. The authors have proposed SSL2, a novel predictive factor, for impacted stones and the short-term SFS after SWL. They have concluded that combining SSL2 with MSD would surely help more accurate decision-making for patients with ureteral stones. The author has nothing to report. The author declares no conflicts of interest.