Stepwise Description and Outcomes of Bladder Neck Sparing Robot-Assisted Simple Prostatectomy

Area of Science:

• Urology
• Robotic Surgery
• Surgical Techniques

Background:

• Benign prostate hyperplasia (BPH) affects a significant portion of the aging male population.
• Traditional simple prostatectomy can lead to complications such as incontinence and ejaculatory dysfunction.
• Robot-assisted simple prostatectomy (RASP) offers potential advantages in minimally invasive surgery.

Purpose of the Study:

• To describe the stepwise technique of bladder neck sparing (BNS) robot-assisted simple prostatectomy (RASP).
• To evaluate the perioperative and postoperative outcomes of BNS RASP.
• To assess the feasibility and reproducibility of this simplified surgical approach.

Main Methods:

• Retrospective review of 30 consecutive patients undergoing BNS RASP between March 2015 and December 2018.
• Data abstracted included baseline characteristics, intraoperative variables, and postoperative functional outcomes.
• Descriptive statistics were used to analyze the collected data.

Main Results:

• The median patient age was 66.5 years, with a median prostate size of 97 mL.
• Mean operative time was 107.5 minutes with a mean estimated blood loss of 132.4 mL.
• All patients achieved postoperative continence, and 42% of those with preoperative antegrade ejaculation maintained it.

Conclusions:

• Bladder neck sparing robot-assisted simple prostatectomy is a reproducible technique with favorable perioperative complication rates.
• The procedure demonstrates acceptable postoperative functional outcomes, including urinary continence.
• This simplified approach eliminates the need for continuous bladder irrigation and intraperitoneal drains.