The title of this book is a challenge. Anyone with the least
knowledge of present day urology will know that there are many very
controversial aspects of this subject. Urology is not alone in this
unsettled environment for there are similar debates in almost all
other aspects of surgery. In addition to the rapid changes in
technology, an important part of the explanation for these
controversies is simply that more surgeons are prepared to admit
that no area of their work is so established that it does not bear
further scrutiny and assessment. Argument can be tedious but debate
is healthy. This book aims to present material that is debatable:
experienced practitioners of each topic explain why an opinion or
preference can be sustained. The purist might wish to have these
opinions resolved by a well-planned clinical trial, but experience
of clinical trials shows that they do not always produce results
that are easily translated into a positive change in clinical
practice. Would the reader be persuaded more by a statistically
significant difference or by an experienced clinician who has
reached certain conclusions? Both are risky, but since surgical
techniques are often not easily converted into appropriate studies
or trials the Editors have obtained the best opinion on each
controversy and innovation. The media adore controversy for its own
sake. The medical profession accepts controversy but knows that few
events in medicine are absolute and few procedures can be done only
by one method.
General
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