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Urethra-Sparing Robot-Assisted Simple Prostatectomy for Postoperative Antegrade Ejaculation.

Sae Woong Choi¹, Dong Wan Sohn¹, U-Syn Ha²

¹Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea.

Journal of Clinical Medicine

|July 29, 2023

Summary

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This study compared extraperitoneal urethra-sparing robot-assisted simple prostatectomy (EUS-RASP) with standard RASP for large prostates. EUS-RASP demonstrated shorter recovery times and preserved ejaculatory function, proving effective and feasible.

Area of Science:

Urology
Robotic Surgery
Prostate Health

Background:

Benign prostatic hyperplasia (BPH) affects a significant portion of the aging male population.
Large prostate volumes (>80 mL) present surgical challenges.
Robot-assisted simple prostatectomy (RASP) is a common treatment for BPH.

Purpose of the Study:

To compare the outcomes of extraperitoneal urethra-sparing RASP (EUS-RASP) versus standard RASP (Freyer approach).
To evaluate perioperative and functional outcomes in patients with large prostates (>80 mL).
To assess the impact on voiding and ejaculatory function.

Main Methods:

A comparative study included 32 patients undergoing EUS-RASP and 30 patients undergoing RASP.
Prospective collection of perioperative and 6-month follow-up data.

Keywords:

benign prostatic hyperplasia ejaculation function robotic surgery simple prostatectomy

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Retrospective evaluation of baseline characteristics, International Prostate Symptom Scores (IPSSs), quality of life (QOL), maximum flow rate, post-void residual volume, and sexual function (in EUS-RASP group).

Main Results:

Both EUS-RASP and RASP groups showed comparable baseline characteristics and functional outcomes.
EUS-RASP resulted in significantly shorter operative time (123.4 vs. 133.7 min), hospital stay (2.9 vs. 4.6 days), and catheterization time (2.4 vs. 8.1 days).
In the EUS-RASP group, 78.6% of patients with preoperative normal ejaculatory function maintained antegrade ejaculation postoperatively.

Conclusions:

Extraperitoneal urethra-sparing RASP is an effective and feasible surgical option for managing large prostates.
EUS-RASP offers advantages in terms of reduced recovery time.
The technique shows promise for preserving ejaculatory function while improving voiding in patients with large prostates.