Moving beyond the headlines: Improving the technical quality of radical prostatectomy

摘要

Radical prostatectomy has gotten some significant bad press over the last several years. Much of the controversy around this signature urologic procedure has come from two sources. First, many have questioned the overall value of surgical therapy for men with early stage prostate cancer, a sentiment fueled in large part by the frequency of adverse functional outcomes (ie, urinary incontinence, erectile dysfunction) believed to relate, at least in part, to technical aspects of the surgical procedure [1-3]. Second, recent reports in the scientific and lay literature describing major complications after robotic prostate cancer surgery have prompted increased scrutiny around the training requirements and technical proficiency necessary to perform unsupervised robotic prostatectomy [4]. For these and other reasons, many have expressed the need for clinically relevant, robust, and practical strategies for assessing and ultimately improving technical expertise with radical prostatectomy [5-7].