This special issue of UroPrecision (Volume 4, Issue 1) brings together 8 high-quality articles, including 6 Special Issue Articles and 2 Regular Articles, written by internationally recognized experts, focusing on the most discussed “Hot Topics” in sexual medicine and andrology. The issue addresses conditions that remain discussable and not widely defined, rather than comprehensively covering all developments. All manuscripts are written under the guidance of recent literature and aim to update physicians on current, evidence-based information. Below are summaries of each contribution.
SPECIAL ISSUE ARTICLES
1. Distinct themes for the advanced practice providers in andrology
This editorial introduces the special issue, which focuses on the latest and most discussed “Hot Topics” in sexual medicine. Rather than comprehensively covering all developments, the issue addresses conditions that remain discussable and not widely defined. All manuscripts are written by internationally recognized authors and aim to update physicians on current, evidence-based information.
DOI: 10.1002/uro2.70058
2. Erectile and ejaculatory outcomes after holmium laser enucleation of the prostate: A comprehensive narrative review
This review critically evaluates the effects of holmium laser enucleation of the prostate (HoLEP) on male sexual function. The literature indicates that HoLEP has a neutral to modestly favorable effect on erectile function, with transient declines typically returning to baseline by 3–6 months. However, retrograde ejaculation is frequent, with incidence rates of 74%–78%. While ejaculation-sparing techniques exist, robust evidence for routine use is lacking.
DOI: 10.1002/uro2.70030
3. Penile traction therapy after radical pelvic surgery: Does it work?
This review examines penile traction therapy (PTT) as a non-invasive rehabilitation option after radical pelvic surgery. PTT may stimulate tissue remodeling, preserve length, and reduce fibrosis. Preliminary studies suggest early initiation may help maintain penile length and erectile function. Although off-label, PTT is a promising component of multimodal rehabilitation, though adoption is limited by cost, insurance, and lack of standardized protocols.
DOI: 10.1002/uro2.70043
4. Penile rehabilitation in men after radical robotic prostatectomy: Fact or fiction?
This review summarizes current penile rehabilitation strategies including PDE5 inhibitors, intracavernosal injections, and vacuum devices, as well as emerging options like shockwave and stem cell therapy. Despite widespread use, no standardized protocol exists. Psychosocial support, partner involvement, and multidisciplinary care are essential for optimizing outcomes.
DOI: 10.1002/uro2.70047
5. Preserving the neurovascular bundle during radical robotic prostatectomy: Tips and tricks
This review provides an overview of nerve-sparing techniques during robot-assisted radical prostatectomy (RARP). Nerve-sparing surgery (NSS) significantly improves postoperative erectile function and urinary continence but must be balanced with oncological safety. Success depends on careful patient selection and precise intraoperative decision-making.
DOI: 10.1002/uro2.70050
6. Supersonic transporter (SST) deformity of penile prosthesis: Current management strategies
This review synthesizes current management of supersonic transporter (SST) deformity (floppy glans syndrome) after IPP implantation. Caused by inadequate dilation, undersized cylinders, or glans hypermobility. Conservative measures may help mild cases, but durable correction is achieved through glanulopexy, with success rates exceeding 85%–95% and low morbidity.
DOI: 10.1002/uro2.70044
REGULAR ARTICLES
7. Renal cell carcinoma with atypical omental metastasis: A case report and literature review
This case report describes a 48-year-old male with synchronous fumarate hydratase-deficient (FH-deficient) renal cell carcinoma (RCC) and isolated omental metastasis at diagnosis—a rare presentation. Unlike most cases with clear cell histology and postoperative spread, this involves an aggressive non-clear-cell subtype with atypical metastatic behavior. The case highlights the need to consider atypical metastatic patterns in non-clear-cell RCC.
DOI: 10.1002/uro2.70032
8. AMHR2 mutation in persistent Müllerian duct syndrome: A case of transverse testicular ectopia
This case reports a 4-month-old male with persistent Müllerian duct syndrome (PMDS) presenting with transverse testicular ectopia. Laparoscopic orchiopexy was performed with preservation of Müllerian structures to protect future fertility. Genetic testing identified two novel anti-Müllerian hormone receptor type 2 (AMHR2) mutations (c.322A>C and c.658G>C), expanding the mutational spectrum of AMHR2-related PMDS.
DOI: 10.1002/uro2.70046