Robotic-assisted Urethra-sparing Simple Prostatectomy Via an Extraperitoneal Approach

Area of Science:

• Urology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Benign prostatic hyperplasia (BPH) affects a significant portion of the aging male population.
• Traditional simple prostatectomy can lead to complications such as ejaculatory dysfunction.
• There is a need for effective BPH treatments that preserve sexual function.

Purpose of the Study:

• To introduce and evaluate an original technique: robotic-assisted urethra-sparing simple prostatectomy (RAUSP).
• To assess the feasibility and outcomes of RAUSP in patients with BPH.

Main Methods:

• A cohort of 27 patients with BPH underwent RAUSP using an extraperitoneal approach between April 2015 and December 2016.
• Data collected included patient characteristics, perioperative outcomes, complications (Clavien), and functional assessments (IPSS, IIEF, ejaculatory function).

Main Results:

• RAUSP was successfully performed in 96.3% of patients, with one conversion to open simple prostatectomy.
• Median operative time was 169 minutes, and median estimated blood loss was 235 mL.
• Significant improvements in International Prostate Symptom Score (P < .001) and quality of life were observed postoperatively, with 13 of 14 patients maintaining normal antegrade ejaculation.

Conclusions:

• Robotic-assisted urethra-sparing simple prostatectomy (RAUSP) is a technically feasible procedure for BPH.
• The technique offers a short catheterization duration and an acceptable risk profile.
• RAUSP effectively improves voiding function while preserving antegrade ejaculation, making it a valuable option for BPH management.