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Published Online: 4 August 2022

A Transition Toward a Faster Recovery in Single-Port Transvesical Simple Prostatectomy

Publication: Journal of Endourology
Volume 36, Issue Number 8

Abstract

Objectives: To present the updated technique and evaluate the perioperative and postoperative outcomes of single-port transvesical simple prostatectomy (SP TVSP)
Patients and Methods: Forty-two consecutive patients with benign prostatic hyperplasia indicated for surgery underwent SP TVSP in a single institution. Through direct suprapubic bladder access, the SP robot was docked. Prostatic enucleation was performed using the prostatic capsule as a landmark. Then a complete vesicourethral mucosal advancement flap was accomplished. Demographics, perioperative, and postoperative data were prospectively collected. Mean follow-up period was 12 months.
Results: All procedures were effectively performed with no conversion, additional port placement, or intraoperative complication. The median prostatic volume was 170 cc. Ninety-five percent of the patients did not require opioids analgesia after discharge. Excluding planned admissions, 92% (21/23 patients) were discharged after a median (interquartile range) of 4.6 (4.1–5.7) hours after surgery. The median Foley catheter duration for all cohort was 7 days, and decreased to 3 days after technique adjustment for the last 19 consecutive patients. The median international prostate symptom score decreased from 23 before surgery to 2.5 after surgery. All patients had a significant postoperative improvement in maximum flow rate with a 200% improvement over baseline (19 vs 6.5 mL/sec).
Conclusion: In our initial series, SP TVSP allows for favorable perioperative and early postoperative outcomes including low complication same-day discharge, short Foley catheter stay, minimal opioids use, and quick recovery.

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Published In

cover image Journal of Endourology
Journal of Endourology
Volume 36Issue Number 8August 2022
Pages: 1036 - 1042
PubMed: 35473428

History

Published online: 4 August 2022
Published in print: August 2022
Published ahead of print: 20 May 2022
Published ahead of production: 27 April 2022

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Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Aaron Kaviani
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Ethan L. Ferguson
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Alp Tuna Beksac
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Mohamed Eltemamy
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Jihad Kaouk [email protected]
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Notes

Address correspondence to: Jihad Kaouk, MD, FACS, FRCS, Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Q10, Cleveland, OH 44195, USA [email protected]

Authors' Contributions

All authors have contributed to the article. Conception and design were carried out by M.A.Z., M.E., and J.K. Acquisition of data was done by M.A.Z., A.K., E.F., and A.T.B. Analysis and interpretation of data were done by M.A.Z. Drafting of the article was taken care of by M.A.Z. and A.K. Critical revision was done by J.K. and M.E.

Author Disclosure Statement

J.K. is a speaker bureau for Intuitive Surgical Company.

Funding Information

No funding was received for this article.

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