MP59-05 PERI-OPERATIVE AND SHORT-TERM FUNCTIONAL OUTCOMES COMPARISON BETWEEN HOLEP AND ROBOTIC SIMPLE PROSTATECTOMY FOR LARGE PROSTATE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP59-05 PERI-OPERATIVE AND SHORT-TERM FUNCTIONAL OUTCOMES COMPARISON BETWEEN HOLEP AND ROBOTIC SIMPLE PROSTATECTOMY FOR LARGE PROSTATE Giovanni Cochetti, Morgan Roupret, Alessio Paladini, Thomas Seisen, Christophe Vaessen, Ugo Pinar, Sara Ciarletti, Angelica Tancredi, Eleonora Saqer, Liliana Guadagni, Emmanuel Chartier-kastler, and Ettore Mearini Giovanni CochettiGiovanni Cochetti More articles by this author , Morgan RoupretMorgan Roupret More articles by this author , Alessio PaladiniAlessio Paladini More articles by this author , Thomas SeisenThomas Seisen More articles by this author , Christophe VaessenChristophe Vaessen More articles by this author , Ugo PinarUgo Pinar More articles by this author , Sara CiarlettiSara Ciarletti More articles by this author , Angelica TancrediAngelica Tancredi More articles by this author , Eleonora SaqerEleonora Saqer More articles by this author , Liliana GuadagniLiliana Guadagni More articles by this author , Emmanuel Chartier-kastlerEmmanuel Chartier-kastler More articles by this author , and Ettore MeariniEttore Mearini More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003312.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium Laser enucleation of Prostate (HoLEP) and open simple prostatectomy (OSP) are recommended treatments for large benign prostate hyperplasia (BPH). Robot-assisted simple prostatectomy (RASP) seems comparable to open simple prostatectomy (OSP) in terms of efficacy and safety, providing similar improvements in Qmax and IPSS, but with advantages of minimally invasive technique. It remains unclear which is the best treatment between HoLEP and RASP. The aim of the study was to compare these techniques in terms of perioperative data, short-term functional outcomes in patients (pts) with prostate larger than 100 cc. METHODS: From January 2016 to January 2022, data from 94 pts with BPH >100 cc who underwent HoLEP or RASP were retrospectively analyzed. Overall, 47 pts underwent HoLEP and 47 underwent RASP. Operative time (OT), blood loss evaluated as ΔHb, length of catheterization (LOC), length of stay (LOS), IPSS, quality of life (QoL) index, urgency, maximum flow rate (Qmax), PSA, complications and urinary continence were analyzed at 30 and 90 days after surgery. Statistical analysis was made with T-test or Wilcoxon test for parametric and non-parametric continuous variables, respectively. Chi-square test was used for percentage variables. Statistical significance was set at p<0.05. RESULTS: The groups were comparable in terms of age, BMI, pre-operative IPSS and QoL index. The mean prostate volume was similar even if in HoLEP group was slightly lower (128.4±23.9 vs 144±34.1 cc, p>0.05). LOC (2.4±0.9 vs 4.5±1.5 days, p=0.003) and LOS (3.5±1.1 vs 5±1.8 days, p=0.002) were significantly shorter for HoLEP group. No differences were observed in post-operative ΔHb, QoL, IPSS, urgency and urinary continence at 30 and 90 days after surgery. Otherwise, OT of RASP was significantly lower than HoLEP (107,5±20,1 vs 178,9±62 min, p<0.05), while at 3 months Qmax and PSA value were higher and lower, respectively, in HoLEP group (33.2±12.4 vs 24.5±15.3 ml/sec, p=0.03 and 0.8± vs 1.6± ng/ml, p=0.003). No intraoperative complication according to EAUiaiC occurred and only minor postoperative complications according to Clavien Dindo classification were observed without significant differences (4,25% for HoLEP vs 10.6% for RASP, p=0.27). CONCLUSIONS: Compared to RASP, HoLEP shows advantages in reducing LOC and LOS, but needs of longer OT. Lower levels of PSA in HoLEP, that could be the result of more tissue removal, and the better Qmax do not affect IPSS and QoL in peri-operative and short-term outcomes. HoLEP and RASP are both safe and effective enucleative techniques. Probably, RASP could be more useful for pts with larger BPH and multiple vesical lithiasis or large diverticulum. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e807 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Cochetti More articles by this author Morgan Roupret More articles by this author Alessio Paladini More articles by this author Thomas Seisen More articles by this author Christophe Vaessen More articles by this author Ugo Pinar More articles by this author Sara Ciarletti More articles by this author Angelica Tancredi More articles by this author Eleonora Saqer More articles by this author Liliana Guadagni More articles by this author Emmanuel Chartier-kastler More articles by this author Ettore Mearini More articles by this author Expand All Advertisement PDF downloadLoading ...