Evaluating Surgical Outcomes of Robot Assisted Simple Prostatectomy in the Retreatment Setting

Area of Science:

• Urology
• Surgical Outcomes
• Benign Prostate Enlargement

Background:

• Benign prostate enlargement (BPE) is a common condition in aging men.
• Endoscopic procedures are frequently used for BPE treatment.
• Salvage procedures may be necessary after initial treatments fail or complications arise.

Purpose of the Study:

• To compare perioperative and postoperative outcomes of salvage Robotic-Assisted Simple Prostatectomy (sRASP) with primary RASP (pRASP) for BPE.
• To evaluate the safety and efficacy of sRASP in men with prior endoscopic BPE procedures.

Main Methods:

• A prospectively maintained database of RASP surgeries from December 2014 to October 2019 was reviewed.
• Patients were divided into two groups: sRASP (prior endoscopic procedure) and pRASP (no prior procedure).
• Perioperative, postoperative, functional, and quality of life outcomes were compared between groups.

Main Results:

• 310 men underwent RASP; 30 (9.7%) had prior endoscopic procedures.
• No significant differences were observed in age, BMI, prostate volume, or preoperative retention.
• While primary RASP patients had higher preoperative symptom scores, functional and quality of life outcomes, as well as complication and incontinence rates, were similar between sRASP and pRASP groups.

Conclusions:

• Robotic-Assisted Simple Prostatectomy is a safe and effective option for men requiring salvage treatment after prior endoscopic procedures for BPE.
• Outcomes and complication rates for sRASP are comparable to those for pRASP.
• sRASP offers a viable solution for BPE management in previously treated patients.