Trans-rectovesical pouch urethral-sparing robotic-assisted simple prostatectomy: A case series

Area of Science:

• Urology
• Robotic Surgery
• Surgical Techniques

Background:

• Benign prostatic hyperplasia (BPH) affects a large number of aging men.
• Traditional simple prostatectomy can lead to complications like ejaculatory dysfunction.
• Novel techniques are needed to improve outcomes for BPH surgery.

Purpose of the Study:

• To detail a novel technique for robotic-assisted simple prostatectomy (usRASP).
• To facilitate handling of prostates protruding into the bladder neck.
• To preserve urethral function and maintain ejaculation post-surgery.

Main Methods:

• Prospective case series of 17 male patients with large volume (>80 mL) BPH.
• Trans-rectovesical pouch urethral-sparing robotic-assisted simple prostatectomy (usRASP) was performed.
• A specific surgical approach was adopted to avoid certain anatomical structures.

Main Results:

• Median intravesical prostatic protrusion was 19.3 mm.
• Median operative time was 100 minutes with median blood loss of 100 mL.
• Post-surgery, median maximum urine flow rate improved, and 58% of patients retained normal ejaculation function.

Conclusions:

• A new approach to usRASP was successfully described.
• This technique improved voiding function and maintained antegrade ejaculation.
• The novel method did not increase post-operative complications.