Outcomes of Robotic Simple Prostatectomy After Prior Failed Endoscopic Treatment of Benign Prostatic Hyperplasia
Abstract
Background: We compared outcomes of robot-assisted simple prostatectomy (RASP) in patients with and without a history of prior prostate surgery for management of symptomatic benign prostatic hyperplasia (BPH).
Methods: We retrospectively reviewed our multi-institutional database for all consecutive patients who underwent RASP between May 2013 and January 2021. Postoperatively, urinary function was assessed using the American Urological Association symptom score (AUASS) and quality of life (QOL) score.
Results: Overall, 520 patients met inclusion criteria. Among the 87 (16.7%) patients who underwent prior prostate surgery, 49 (56.3%), 26 (29.9%), 8 (9.2%), 3 (3.4%), and 1 (1.1%) patients underwent transurethral resection of the prostate, photoselective vaporization of the prostate, transurethral microwave therapy, prostatic urethral lift, or water vapor thermal therapy, respectively. There was no difference in mean prostate volume (p = 0.40), estimated blood loss (p = 0.32), robotic console time (p = 0.86), or major 30-day postoperative (Clavien >2) complications (p = 0.80) between both groups. With regard to urinary function, the mean improvement in preoperative and postoperative AUASS (p = 0.31), QOL scores (p = 0.11), and continence rates was similar between both groups.
Conclusion: For management of patients with BPH and lower urinary tract symptoms, RASP is associated with an improvement in urinary function outcomes and a low risk of postoperative complications. Perioperative outcomes of RASP are similar in patients who underwent prior prostate surgery vs those that did not undergo prior prostate surgery.
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Copyright 2023, Mary Ann Liebert, Inc., publishers.
History
Published online: 15 May 2023
Published in print: May 2023
Published ahead of print: 12 April 2023
Published ahead of production: 16 March 2023
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Authors' Contributions
M.L. contributed to conceptualization, methodology, formal analysis, data curation, and writing. D.S. was involved in data curation. Z.L. carried out data curation, supervision, and visualization. A.H. oversaw data curation, supervision, and visualization. D.D.E. took charge of conceptualization, supervision, and visualization.
Author Disclosure Statement
M.L., D.S., and A.H. have no competing financial interests. Z.L. is a consultant for Boston Scientific and receives educational grants from Intuitive Surgical. D.D.E. is a paid speaker, consultant, and proctor for Intuitive Surgical, a consultant for Johnson and Johnson, and is a founder/part owner of Melzi Corp.
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No funding was received for this article.
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