MP13-14 ROBOT-ASSISTED SIMPLE PROSTATECTOMY VERSUS HOLMIUM LASER ENUCLEATION FOR THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA IN LARGE (>100 ML) PROSTATES: UPDATED COMPARATIVE ANALYSIS FROM A HIGH-VOLUME CENTER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP13-14 ROBOT-ASSISTED SIMPLE PROSTATECTOMY VERSUS HOLMIUM LASER ENUCLEATION FOR THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA IN LARGE (>100 ML) PROSTATES: UPDATED COMPARATIVE ANALYSIS FROM A HIGH-VOLUME CENTER Mottaran Angelo, Eleonora Balestrazzi, Carlo Andrea Bravi, Luigi Nocera, Marco Paciotti, Adele Piro, Maria Peraire Lores, Luca Sarchi, Federico Piramide, Pieter De Backer, Ruben De Groote, Geert De Naeyer, Peter Schatteman, and Alexandre Mottrie Mottaran AngeloMottaran Angelo More articles by this author , Eleonora BalestrazziEleonora Balestrazzi More articles by this author , Carlo Andrea BraviCarlo Andrea Bravi More articles by this author , Luigi NoceraLuigi Nocera More articles by this author , Marco PaciottiMarco Paciotti More articles by this author , Adele PiroAdele Piro More articles by this author , Maria Peraire LoresMaria Peraire Lores More articles by this author , Luca SarchiLuca Sarchi More articles by this author , Federico PiramideFederico Piramide More articles by this author , Pieter De BackerPieter De Backer More articles by this author , Ruben De GrooteRuben De Groote More articles by this author , Geert De NaeyerGeert De Naeyer More articles by this author , Peter SchattemanPeter Schatteman More articles by this author , and Alexandre MottrieAlexandre Mottrie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003233.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In patients with large benign prostatic hyperplasia (BPH), both Holmium Laser Enucleation of Prostate (HoLEP) and Robot-Assisted Simple Prostatectomy (RASP) are possible treatment options. While both techniques have advantages and disadvantages, comparative evidence on peri-operative outcomes of these operations for the treatment of large prostates (>100 ml) is still limited. Therefore, our aim was to update our comparative analysis of HoLEP vs. RASP for the treatment of BPH in patients with large (>100 ml) prostate volumes. METHODS: We analyzed data of 339 patients with symptomatic BPH due to large (>100 ml) prostates glands who underwent RASP (n=130, 35%) and Holep (n=239, 65%) at OLV Hospital, Aalst (Belgium) between 2011 and 2021. We collected pre-operative baseline characteristics and peri-operative outcomes; peri-operative complications were reported according to the Clavien-Dindo classification. Functional parameters were assessed postoperatively 3 months after surgery. We compared pre-operative characteristics, operative time and peri- and post-operative outcomes between the groups. RESULTS: Baseline characteristics – including age, BMI, preoperative IPSS score, preoperative maximum flow and post-voidal residue (PVR) – did not differ between patients receiving RASP vs. HoLEP (all p>0.05). As compared to HoLEP, patients treated with RASP had bigger prostates at preoperative imaging (median: 159 (115, 200) ml vs. 120 (110, 140) ml; p<0.001). Median operation time (100 min vs. 120 min), catheterization time (2 vs. 3 days) and length of stay (2 vs. 4 days) were slightly shorter in the HoLEP group (all p<0.001). On final pathology, median prostate weight was similar between the groups (100 gr vs. 105 gr; p=0.4). Complication rates were similar in both groups (rate of all Clavien-Dindo complications: 23% vs. 22%; p=0.2). At 3 months follow up, both groups showed an improvement of maximum flow rate (+12 vs. +13.3 ml/s; p=0.4), a reduction of PVR (-93 vs. -75 ml; p=0.9) and IPSS score (-16 vs. -12; p=0.2). CONCLUSIONS: Our study provided relevant data on peri-operative outcomes of RASP and Holep, and might help clinicians in preoperative counselling for men with large (>100 ml) prostates requiring surgery for BPH. While patients receiving RASP had slightly longer hospital stay, both techniques achieved excellent results in this patient population, and represent valuable treatment option according to physician preferences and expertise. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e178 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mottaran Angelo More articles by this author Eleonora Balestrazzi More articles by this author Carlo Andrea Bravi More articles by this author Luigi Nocera More articles by this author Marco Paciotti More articles by this author Adele Piro More articles by this author Maria Peraire Lores More articles by this author Luca Sarchi More articles by this author Federico Piramide More articles by this author Pieter De Backer More articles by this author Ruben De Groote More articles by this author Geert De Naeyer More articles by this author Peter Schatteman More articles by this author Alexandre Mottrie More articles by this author Expand All Advertisement PDF downloadLoading ...