Stepwise Description and Outcomes of Bladder Neck Sparing Robot-assisted Simple Prostatectomy.

To present a stepwise description and outcomes of bladder neck sparing robot-assisted simple prostatectomy (RASP).

Between March 2015 and December 2018, a total of 30 consecutive patients with Benign Prostatic Hyperplasia (BPH) underwent bladder neck sparing RASP.

Baseline characteristics, intraoperative and postoperative variables were retrospectively abstracted. Descriptive statistics were employed to report the variables.

The median age was 66.5 (59.3-72.3), and median body mass index was 27.6 (24.5-72.3) kg/m2. The median preoperative IPSS was 23 (17.5-27), and median prostate size was 97 (74-148.75) ml; The mean (SD) operative time was 107.5 (22.2) minutes, and the mean (SD) estimated blood loss was 132.4 (35.4) ml. All cases were completed robotically without any intra-operative complications, and continuous bladder irrigation was not necessary for any patient postoperatively. All patients were able to void after catheter removal except one patient with a preexisting diagnosis of neurogenic bladder who resumed clean intermittent catheterization. All patients were continent as defined as using 0 pads postoperatively. Of the 19 patients who had antegrade ejaculation before surgery, 8 patients (42%) reported of continued antegrade ejaculation after surgery.

In this report, we demonstrate a simplified approach of bladder neck sparing RASP that is easily reproducible with a short learning curve, favorable perioperative complication rates and acceptable postoperative functional outcomes. This technique obviates the need for continuous bladder irrigation as well as intraperitoneal drain.

Journal of endourology. 2020 Mar 18 [Epub ahead of print]

Mohammed Shahait, Kinnari Patel, Suzy Na, Jessica Kim, Ayah El-Fahmawi, Ryan W Dobbs, David I Lee

University of Pennsylvania, 6572, Urology , Philadelphia, Pennsylvania, United States; ., University of Pennsylvania, 6572, Urology , Philadelphia, Pennsylvania, United States; ., University of Pennsylvania, 6572, Surgery, 51 N. 39th Street, MOB 300, Philadelphia, Pennsylvania, United States, 19104; ., University of Pennsylvania, 6572, Surgery, 51 N. 39th St. MOB 300, Philadelphia, Pennsylvania, United States, 19104; ., University of Pennsylvania Health System, 6569, Division of Urology, Dept of Surgery, 51 N. 39th Street, MOB 300, Philadelphia, Pennsylvania, United States, 19104; ., University of Pennsylvania Perelman School of Medicine, 14640, Surgery, 3400 Spruce Street, 4 Maloney, Philadelphia, Philadelphia, Pennsylvania, United States, 19104; ., University of Pennsylvania Health System, 6569, Division of Urology, Dept of Surgery, Philadelphia, Pennsylvania, United States; .

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