A prospective comparative analysis of robot-assisted vs open simple prostatectomy for benign prostatic hyperplasia

Area of Science:

• Urology
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Benign prostatic hyperplasia (BPH) affects a significant portion of the aging male population.
• Surgical intervention is often necessary for managing large prostate glands.
• Traditional open simple prostatectomy (OSP) has been the standard, but minimally invasive options are emerging.

Purpose of the Study:

• To conduct the first prospective comparative analysis of robot-assisted simple prostatectomy (RASP) versus open simple prostatectomy (OSP).
• To evaluate and compare the postoperative and functional outcomes of RASP and OSP in patients with large prostate glands.

Main Methods:

• A prospective analysis of 41 patients undergoing surgery for BPH between 2014 and 2017.
• Patients were grouped into OSP or RASP and matched for key demographic and clinical factors.
• Follow-up was conducted for 3 months, comparing postoperative and functional outcomes.

Main Results:

• RASP demonstrated significantly lower blood loss (274 mL vs 539 mL) but longer operating times (134 min vs 88 min) compared to OSP.
• RASP had fewer serious complications (27% vs 7%) including no bladder ruptures or DVT, whereas OSP had 4 serious complications.
• Both RASP and OSP showed similar significant improvements in International Prostate Symptom Scores, uroflowmetry, and post-void residual urine volume.

Conclusions:

• Robot-assisted simple prostatectomy (RASP) achieves functional outcomes comparable to open simple prostatectomy (OSP).
• RASP presents a favorable safety profile, potentially superior to OSP, with reduced blood loss and fewer severe complications.
• RASP is a viable, efficient, and potentially superior alternative for treating large prostate glands in BPH patients.