The aim of our study is to assess the differences in functional outcomes during the perioperative and postoperative period after RASP depending on BPH volume.
We searched 2 databases: MEDLINE (PubMed) and Google Scholar using the following search query: robot* AND "simple prostatectomy".
The search strategy and review protocol are available at Prospero (CRD42024508071).
We included 25 articles published between 2008 and 2023. Preoperatively, patients with prostate size < 100 cm3 had more severe symptoms while postoperatively all of them had only mild lower urinary tract symptoms (LUTS). In larger BPH, two authors reported moderate LUTS after RASP: Fuschi [1] (mean IPSS 8.09 ± 2.41) and Stolzenburg [2] (mean IPSS 8 ± 2.7). Postoperative Qmax was also noticeably higher in smaller BPH (mean value range 28.5-55.5 ml/s) compared to larger BPH (mean Qmax 18-29.6 ml/s), although in both groups it was within the normal range. Postoperative post-void residual (PVR) was normal as well except in one study by Stolzenburg et al. [2]. Blood loss was comparable between the groups. The complications rate in general was low.
RASP is effective in terms of subjective and objective urination indicators, and a safe procedure for BPH. In the lack of data on implementation of RASP in small prostate volumes, this procedure can be seen as an upper size «limitless» treatment alternative. Currently, comparative data regarding prostate volume is lacking, and future trials with subgroups analysis related to BPH volume might help to address this issue.
World journal of urology. 2024 Oct 08*** epublish ***
Andrey Morozov, Svetlana Bogatova, Evgeny Bezrukov, Nirmish Singla, Jeremy Yuen-Chun Teoh, Leonid Spivak, Juan Gomes Rivas, Lukas Lusuardi, Vineet Gauhar, Bhaskar Somani, David Lifshitz, Jack Baniel, Thomas R W Herrmann, Dmitry Enikeev
Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia., Institute for Clinical Medicine, Sechenov University, Moscow, Russia., Department of Urology, James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, USA., Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, Hospital Clínico San Carlos, Madrid, Spain., Department of Urology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria., Ng Teng Fong General Hospital, NUH, Singapore, Singapore., Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK., Department of Urology, Rabin Medical Center, Petach Tiqwa, Israel., Department of Urology, Spital Thurgau AG, Kantonspital Frauenfeld, Frauenfeld, Switzerland., Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/39377921