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Published on: May 19, 2022
Intermediate-term Urinary Function and Complication Outcomes After Robot-Assisted Simple Prostatectomy
Ziho Lee1, Matthew Lee1, Aryeh Y Keehn2
1Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.
Objective:
To assess the incidence of delayed complications after robot-assisted simple prostatectomy and evaluate postoperative lower urinary tract symptoms (LUTS) as a function of time with intermediate-term follow-up.
Methods:
We retrospectively reviewed 150 patients who underwent robot-assisted simple prostatectomy between May, 2013 and January, 2019. Indication for surgery was bothersome LUTS refractory to medical management and prostate volume ≥80 milliliters. The severity of LUTS was assessed using the International Prostate Symptom Score (IPSS) and quality of life (QOL) score. One-way analysis of variance test with post hoc Tukey's honest significant difference test was used to compare postoperative IPSS and QOL scores as a function of time; P <.05 was considered significant.
Results:
At a mean ± SD follow up of 31.3 ± 18.2 months, none of the patients developed a bladder neck contracture and none of the patients required reoperation for LUTS. Postoperatively, IPSS and QOL scores decreased with an increasing duration of follow up (P <.001). Mean IPSS and QOL scores improved between 2 weeks and 3 months postoperatively (P = .027 and P = .006, respectively). After 3 months postoperatively, mean IPPS and QOL scores stabilized and remained unchanged up to 36 months of follow-up (all P >.05).
Conclusion:
Robotic simple prostatectomy is associated with a low incidence of delayed complications at a mean of 31.3 months postoperatively. After robotic simple prostatectomy, urinary function outcomes improve in the early postoperative period with maximal improvement occurring at 3 months. Excellent urinary function outcomes are durable up to at least 36 months postoperatively.
Insights
Robot-assisted simple prostatectomy shows few delayed complications. Urinary function improves within 3 months and remains stable for up to 36 months post-surgery.
Area of Science:
- Urology
- Robotic Surgery
- Men's Health
Background:
- Benign prostatic hyperplasia (BPH) significantly impacts quality of life due to lower urinary tract symptoms (LUTS).
- Robot-assisted simple prostatectomy (RASP) is an option for managing large prostates causing LUTS refractory to medical treatment.
- Assessing long-term outcomes and delayed complications of RASP is crucial for patient management.
Purpose of the Study:
- To determine the incidence of delayed complications following RASP.
- To evaluate the temporal changes in postoperative lower urinary tract symptoms (LUTS) after RASP.
- To assess the durability of urinary function outcomes up to intermediate-term follow-up.
Main Methods:
- Retrospective review of 150 patients undergoing RASP for prostate volume ≥80 mL.
- Assessment of LUTS using the International Prostate Symptom Score (IPSS) and Quality of Life (QOL) scores.
- Statistical analysis using ANOVA with post hoc Tukey's test to compare scores over time.
Main Results:
- No patients experienced bladder neck contracture or required reoperation for LUTS at a mean follow-up of 31.3 months.
- IPSS and QOL scores significantly improved postoperatively (P <.001).
- Maximal improvement in IPSS and QOL scores occurred by 3 months and remained stable up to 36 months.
Conclusions:
- RASP demonstrates a low rate of delayed complications.
- Urinary function outcomes significantly improve after RASP, peaking at 3 months.
- The positive functional outcomes of RASP are durable for at least 36 months.
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