Purpose:We describe our initial experience with Robotic Intra-fascial Simple Prostatectomy (IF-RSP).
Potential advantages include reduced blood loss, eliminate the need for postoperative bladder irrigation, and eliminate the risk of residual or future prostate cancer, without interrupting potency or continence.
Materials and Methods:From June 2011 to March 2012, 10 patients with symptomatic prostatomegaly on TRUS (mean 81 grams) underwent IF-RSP. Three patients were on acute urinary retention. Demographic perioperative and outcome data were recorded up to 1 month follow-up.
Results:Average age was 71.7 years (range 60 to 79), estimated blood loss was 375 ml (range 150 to 900 ml), operative time was 106 minutes (range 60 to 180), hospital stay was 1 day (range 0 to 3) and Foley catheter duration was 8.9 days (range 6 to 14). Drain was removed at a mean 2.8 days (range 0 to 8). Mean prostate volume on pre-operative TRUS was 81 gr. (range 47 to 153). Mean specimen weight was 81 gr. (range 50 to 150). Improvement was noted in IPSS (preoperative vs. postoperative 18.8 vs. 1.7) and Qmax (12.4 vs. 33.49 ml/min). SHIM score ranged from 12 to 24. All patients were completely continent within 1 month postoperatively and sexual function was preserved. One patient had urinary tract infection and 1 patient required blood transfusion postoperatively.
Conclusions: IF-RSP appears to be a feasible procedure in large-volume prostatomegaly. The entire prostate tissue is removed without compromising continence and potency. Larger series and longer-term follow-up are needed to evaluate the proper place of this approach.
Written by:
Clavijo RA, Carmona O, de Andrade R, Almanzor O, Garza R, Fernandez G, Sotelo RJ. Are you the author?
Instituto Medico la Floresta, Urology, Caracas, Venezuela.
Reference: J Endourol. 2012 Sep 11. Epub ahead of print.
doi: 10.1089/end.2012.0212
PubMed Abstract
PMID: 22966792
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