Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology

MP6-11 - Robot Assisted Adenomectomy for Benign Prostate Hyperplasia

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

Treatment of large prostate glands due to benign prostatic hyperplasia (BPH) has evolved over time. Classic open approach steadily gave its position to transurethral approaches and laparoscopic ones. More recently surgeons published their experience, treating large glands with the robotic platform. We report our initial experience with robot assisted simple prostatectomy for the treatment of BPH and test its efficacy and safety profile.


Methods :

Between December 2014 and December 2017, 37 patients underwent robot assisted adenomectomy for symptomatic BPH due to failure of medical treatment or urinary retention. Ports were placed similar to transperitoneal robot assisted radical prostatectomy, but 1-2 cm. more cranially. All patients were operated by the same surgeon. Adenomectomy was performed via a vertical capsulovesicular incision utilizing sharp and blunt dissection. Patient characteristics, preoperative, intraoperative and postoperative parameters and complications were analyzed.


Results :

Mean patient age was 66.4 (±8.1) years. Mean BMI was 27.4 (±4.9) kg/m2. Preoperative mean PSA was 10.3(±11.9) ng/ml. whereas mean preoperative post residual urine was 254.4 (±204) ml. Twelve patients had preoperative Foley urethral catheter due to relapsed urinary retention. Mean specimen weight was 110.8 (±42.8) grams. Eleven patients had intra-abdominal surgery history; 2 cholecystectomies, 6 inguinal hernia repair and 4 appendectomies. Mean estimated blood loss was 264.4(±291.1) ml. and mean operation time was 133.64 (±29.15) minutes. Mean catheterization time was 3.5 (±0.8) days. No >2 Clavien-Dindo complications were observed. In one patient, prostate cancer has been diagnosed in final histopathological evaluation despite negative preoperative prostate biopsy. Mean postoperative post-void residual urine was 29.3(±25.1) ml. Preoperative and postoperative average flow rate was 2.6±2.4 and 9.7±5.9 ml/sec., respectively. (Table 1)


Conclusions :

Robot assisted adenomectomy seems to be a safe substitute to the existing therapeutic approaches for larger glands due to BPH.

Mehmet Selçuk Keskin

Assist. Prof
Acibadem Mehmet Ali Aydınlar University School of Medicine Urology department
Istanbul, Istanbul, Turkey

Mustafa Bilal Tuna

MD
Acibadem Maslak Hospital, Department of Urology
Is, Istanbul, Turkey

Tünkut Doğanca

Acıbadem Taksim Hospital
Istanbul, Istanbul, Turkey

İlter Tüfek

Assoc. Prof.
Acibadem Mehmet Ali Aydınlar University School of Medicine Urology Department
Istanbul, Istanbul, Turkey

Ömer Burak Argun

Assoc. Prof.
Acibadem Mehmet Ali Aydınlar University School of Medicine Urology Department
Istanbul, Istanbul, Turkey

Can Öbek

Prof.
Acibadem Taksim Hospital
Istanbul, Istanbul, Turkey

Ali Rıza Kural

Prof.
Acibadem Mehmet Ali Aydınlar University School of Medicine Urology department
Istanbul, Istanbul, Turkey