Robotic-assisted Urethra-sparing Simple Prostatectomy via an Extraperitoneal Approach

To present a original technique of robotic-assisted urethra-sparing simple prostatectomy (RAUSP) for treating patients with benign prostatic hyperplasia (BPH).

From Apr 2015 to Dec 2016, 27 patients underwent RAUSP via an extraperitoneal approach. Baseline patient characteristics, perioperative outcomes, pathological outcomes, postoperative clavien complications, International Prostate Symptom Score, International Index of Erectile Function and ejaculatory function were assessed.

Twenty-six patients (96.3%) successfully underwent RAUSP, one patient (3.7%) was converted to simple prostatectomy. Median operative time was 169 mins (interquartile range: 150-185) ; median estimated blood loss was 235 ml (interquartile range:180-300). Seven cases (26.9%) required urethral repair secondary to inadvertent urethrotomy.. Mean catheterization time was 1.6 days (range 1-5). Clavien complications were reported, 6 being low grade (grade 1 or 2) with a single 3a complication (gross hematuria requiring bladder irrigation). Mean follow-up duration was 16.4 months (range 9-30). Post-operative questionnaire demonstrated that IPSS (p < 0.001) and QOL score (p < 0.001) were significantly improved postoperatively. A total of 14 patients reported erectile function, 13 of which had normal ejaculation, only 1 complained retrograde ejaculation.

RAUSP is technically feasible for patients with BPH. Our data indicate that patients have short catheterization time, an acceptable risk profile, significantly improvements of voiding function and maintaining antegrade ejaculation following this urethral- sparing technique.

Urology. 2018 Jun 14 [Epub ahead of print]

Ping Wang, Dan Xia, SunYi Ye, DeBo Kong, Jie Qin, TaiLe Jing, YeQing Mao, HongZhou Meng, Shuo Wang

Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qing'chun Road, Hangzhou, Zhejiang Province, 310003, China., Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qing'chun Road, Hangzhou, Zhejiang Province, 310003, China. Electronic address: .