REDO ROBOTIC SIMPLE PROSTATECTOMY: USC EXPERIENCE
Introduction: Surgical option for symptomatic bladder outlet obstruction associated with benign prostatic hyperplasia (BPH) for patients with prostate >100cc are open simple prostatectomy (OSP) and Holmium Enucleation of the Prostate (HolEP). Robotic simple prostatectomy (RSP) has recently evolved as minimally invasive approach alternative to OSP with improved preoperative morbidity. There is no data of its use in patients that had previous BPH surgery.
Objective: In this study, we investigate the feasibility, safety and functional outcomes of RSP in patient with previous BPH surgery including OSP.
Methods: We retrospectively reviewed the patients that underwent RSP for symptomatic BPH from 2011 and 2017 in our institution and patients that had a previous BPH surgery were selected. Perioperative outcomes including transfusion, complications, length of catheterization and hospitalization were examined. Functional outcomes with a median follow-up of 6 months including IPSS, Qmax and PVR were also analyzed.
Results: Amongst 131 patient that underwent RSP, n=28 had previous BPH procedure: 12 had TURP, 10 TUMT, 4 Greenlight PVP, 1 HolEP and 1 had OSP. Despite these previous surgeries, the mean prostate volume was 143.6 cc and 57% of patients were in retention with catheter. Mean operative time and EBL was 242 min and 149 ml respectively No intra-operative complication or need for transfusion were observed. The mean Hospital stay was 4 days and mean catheterization 7 days. The only significant postoperative complication at 30 days was hematuria clavier 3a in one patient. Post-operative outcomes with a follow up of 6 months including IPSS, Qmax and PVR were all significantly improved compared to baselines.
Conclusions: RSP is feasible and can be a safe and efficient as a surgical option for patients with recurrence of symptomatic BPH prostate size >100cc and who had previous BPH surgery.
Robotic simple Prostatectomy; previous BPH surgery; benign prostatic hyperplasia.
Hiperplasia Prostática Benigna
University of Southern California - - Estados Unidos
Pedro Glusman Knijnik, Pietro Waltrick Brum, Pierre A Hueber, André Abreu, Monish Aron, Inderbir S Gill, Andre K Berger