Radical prostatectomy is the surgical procedure of choice for localized prostate cancer. As prostate cancer has become the first and most common cancer in men the details of this operation are the issue of endless talk and debate by experts, patients, and the public. This book is for those who wish to understand the basic indications, advantages, and disadvantages of surgical approaches to extracting the prostate.

These are also the days of change in the traditional surgical approach to prostatic cancer surgery as the gold standard. Open retropubic radical prostatectomy is being challenged by laparoscopic, and even more, by robotic radical prostatectomy. More than 50% of radical prostatectomies in the United States are performed by computer-assisted laparoscopy (with the proprietary daVinci robotic device). Although no prospective trials are available, this technique is being marketed aggressively. It remains to be seen if this shift will bring a proven advantage to patients. Several proposed answers to this debate lie in this timely book.

The book has several parts which lead the reader from the anatomy, through the oncological principles of the operation, to the options of the open and laparoscopic approach to surgery. The first part covers specialized anatomy of the prostate and its surroundings. Indications and imaging are presented in an updated and very informative way. The second part deals with special anesthesia considerations, which are important because of the awkward angles the patient needs to be positioned in, the elevated intra-abdominal pressures for long periods, and, in many cases, blood loss. Relevant in many procedures, pelvic lymph node dissection is discussed by primary investigators in this field.

The remaining parts of the book, which compare open versus perineal versus laparoscopic versus robotic approaches, are all presented in terms of the merits and pitfalls of each, together with costs and time to convalescence. The aims of all these procedures are to attain a disease-free patient who does not require protective pads or a penile prosthesis. Because this is not always the outcome, the final part of the book is devoted to postoperative considerations, including how to deal with incontinence and impotence, common side effects of prostate procedures.

Altogether, the book is unique in bringing this range of information together. It may be appealing not only for the practicing urologist but also for oncologists and radiotherapists who challenge the traditional operative technique and may gain a more intimate understanding of the options available to the urologist.

This book may also provide medical policy makers with the spectrum of information necessary to asses the risk-benefit of different techniques available for managing prostate cancer. Because the authors are so knowledgeable and eloquent in their writing, this is a very appealing book for all those interested in the subject.