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Laparoscopic simple prostatectomy: a large single-center prospective cohort study.

Anton Zarraonandia Andraca¹, Riccardo Lombardo², Almudena Carrion Valencia¹

¹Pontevedra University Hospital, Pontevedra, Spain.

Minerva Urology and Nephrology

|December 14, 2019

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Laparoscopic simple prostatectomy (LSP) is safe and effective for large prostates. This study found 68% of patients achieved a favorable outcome, with low complication rates.

Area of Science:

Urology
Minimally Invasive Surgery

Background:

Lower urinary tract symptoms (LUTS) and large prostates (>80 cc) require effective treatment options.
Laparoscopic simple prostatectomy (LSP) is an emerging surgical technique.

Purpose of the Study:

To analyze the outcomes and safety of LSP in a high-volume center.
To evaluate the "trifecta" favorable outcome after LSP for benign prostatic hyperplasia.

Main Methods:

Prospective enrollment of 272 men with LUTS and large prostates undergoing LSP.
Outcomes assessed by International Prostate Symptom Score (IPSS), Quality of Life (QoL), prostate-specific antigen, and maximum urinary flow rate (Qmax).
Complications classified using the modified Clavien system; predictors of trifecta outcome identified via logistic regression.

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Main Results:

Statistically significant improvements in IPSS, QoL, and Qmax at three months post-LSP (P<0.001).
Overall complication rate was 21%, with most being low-grade (≤2).
68% of patients achieved the defined positive trifecta outcome; preoperative hemoglobin and hospital stay predicted this.

Conclusions:

Laparoscopic simple prostatectomy (LSP) is a safe and effective treatment for large prostate adenomas.
LSP shows promise for managing LUTS in patients with large prostates, though further RCTs are warranted.