Single-port transvesical versus open simple prostatectomy: a perioperative comparative study

Prostate Cancer Prostatic Dis. 2023 Sep;26(3):538-542. doi: 10.1038/s41391-022-00566-x. Epub 2022 Jul 18.

Abstract

Objective: To compare the initial perioperative outcomes of single-port transvesical simple prostatectomy (SP RASP) patients to those of open simple prostatectomy (OSP).

Patients and methods: Perioperative data from 42 consecutive patients with BPH who underwent SP RASP were prospectively reviewed. Similarly, data from forty-three consecutive patients who underwent the standard OSP, were retrospectively collected. Through direct suprapubic bladder access, prostatic enucleation was performed using the prostatic capsule as a landmark. Then a complete vesicourethral mucosal advancement flap was accomplished. OSP was performed according to the standard approach. Demographics, Intra- and perioperative data were analyzed and assessed with a descriptive analysis.

Results and limitations: Baseline characteristics were comparable between the two groups, except for the preoperative median post-void residual volume, which was higher in the OSP group (p = 0.004). The SP RASP group had less intraoperative estimated blood loss (p < 0.001), no need for continuous bladder irrigation (p < 0.001), and less in-hospital opioid use (p < 0.001). Patients in the SP RASP group were discharged on postoperative day zero, compared to a median of 2 days for OSP (p < 0.001). The median Foley catheter duration was 7 days for SP RASP, compared to a median of 10 days for OSP (p < 0.001). SP RASP group had fewer postoperative complications, however, this did not reach statistical significance.

Conclusion: SP RASP is an alternative approach in treating surgical BPH. It may offer patients less morbidity in comparison to OSP.

MeSH terms

  • Blood Loss, Surgical
  • Humans
  • Length of Stay
  • Male
  • Prostatectomy / methods
  • Prostatic Hyperplasia* / complications
  • Prostatic Hyperplasia* / surgery
  • Prostatic Neoplasms* / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Treatment Outcome