2088 ROBOTIC SIMPLE RETROPUBIC PROSTATECTOMY FOR SEVERE BENIGN PROSTATIC HYPERPLASIA: A PILOT STUDY IN A COMMUNITY SETTING

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology II1 Apr 20102088 ROBOTIC SIMPLE RETROPUBIC PROSTATECTOMY FOR SEVERE BENIGN PROSTATIC HYPERPLASIA: A PILOT STUDY IN A COMMUNITY SETTING David Weeks, and Douglas Sutherland David WeeksDavid Weeks More articles by this author , and Douglas SutherlandDouglas Sutherland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2149AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine the feasibility of robot assisted laparoscopic simple retropubic prostatectomy (RALSP) for men with severe BPH outside of an academic setting. METHODS The procedure was offered to patients with a ultrasound-measured gland size >100 gm who had failed medical management or were in urinary retention. All procedures were performed by two surgeons with a combined experience of >350 robot assisted radical prostatectomy procedures and no prior experience with laparoscopic simple prostatectomy. Patient reported IPSS and SHIM scores were collected prospectively prior to and 3 months after surgery. The RALSP procedure and postoperative management followed previously published laparoscopic techniques. Student t-test was used for statistical comparisons. RESULTS A total of 9 men were treated between 11/08 and 11/09. Indications for RALSP included urinary retention in 1 patient and failed medical management in 8 patients. Average age was 68 years, mean PSA was 17 ng/ml (1.24 - 61), and the average TRUS gland size was 134gm. No operative or immediate postoperative complications occurred and no transfusions were required. One conversion to open was required for failure to progress. Average EBL, operative time and robotic console time was 204cc, 183 min, and 147 min, respectively. Average pathological adenoma volume was 72gm, 53% of the average preoperative TRUS measured volume. Average hospitalization time and catheterization time was 32.3 hours and 13 days, respectively. Average follow-up time was 7 months, and complete IPSS/SHIM data were acquired in 67% (6 of 9). A statistically significant reduction in IPSS scores and post-void residual was identified (see table). No significant difference was identified in SHIM scores. Persistent post-operative urinary incontinence occurred in 1 patient (11%) lasting 6 months. CONCLUSIONS RALSP is safe and reproducible when performed by experienced robotic surgeons providing similar benefits associated with robotic radical prostatectomy. In our limited experience, hemostasis and hospitalization time was markedly decreased compared to the open technique even without preplaced hemostatic sutures, which significantly improved the operative time. Further investigation is necessary before wide spread application of RALSP. Tacoma, WA© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e812 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Weeks More articles by this author Douglas Sutherland More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...