Clinical evaluation of minimum-incision endoscopic radical prostatectomy in initial 50 patients

To assess the feasibility of minimum-incision endoscopic radical prostatectomy (MIERP) in the management of localized prostate cancer.

We conducted clinical evaluations of mean blood loss, operation time, and postoperative course in 50 cases of MIERP performed at Osaka Medical College Hospital from June 2006 to October 2009. The operations were performed according to the MIERP development protocol at our department, with incisions of 10 cm or less in the early cases and 6-7 cm in later cases.

In all 50 cases, average bleeding was significantly shortened compared with 19 cases by the conventional method at our institution. The postoperative start of oral intake, start of ambulation, use of analgesics, timing of catheter removal, and duration of hospitalization were all significantly improved with MIERP compared with the conventional method. MIERP patients were divided into 3 consecutive groups (initial 16 cases, midterm 17 cases, and latest 17 cases); mean operation time/mean blood loss were 253 min/1,485 mL, 253.4 min/2,340.9 mL, and 177 min/1,274 mL, respectively.

Surgical experience involving approximately 30 cases was required to achieve stable clinical results. MIERP is less invasive than conventional retropubic radical prostatectomy and may be safely introduced to resident urologists.