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. 2024 Oct 8;42(1):565.
doi: 10.1007/s00345-024-05264-y.

A systematic review of robot-assisted simple prostatectomy outcomes by prostate volume

Andrey Morozov  1 , Svetlana Bogatova  2 , Evgeny Bezrukov  1 , Nirmish Singla  3 , Jeremy Yuen-Chun Teoh  4 , Leonid Spivak  1 , Juan Gomes Rivas  5 , Lukas Lusuardi  6 , Vineet Gauhar  7 , Bhaskar Somani  8 , David Lifshitz  9   10 , Jack Baniel  9   10 , Thomas R W Herrmann  11   12   13 , Dmitry Enikeev  14   15   16   17
Affiliations

A systematic review of robot-assisted simple prostatectomy outcomes by prostate volume

Andrey Morozov et al. World J Urol. .

Abstract

Purpose: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: Benign prostate hyperplasia; Endoscopic enucleation of the prostate; Robot assisted simple prostatectomy; Simple prostatectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart. From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. 10.1136/bmj.n71
Fig. 2
Fig. 2
Preoperative and postoperative IPSS by the prostate volume. Blue lines show studies with prostate volume < 100 cm3, red lines – with larger prostate volume
Fig. 3
Fig. 3
Preoperative and postoperative Qmax by the prostate volume. Blue lines show studies with prostate volume < 100 cm3, red lines – with larger prostate volume
Fig. 4
Fig. 4
Preoperative and postoperative PVR by the prostate volume. Blue lines show studies with prostate volume < 100 cm3, red lines – with larger prostate volume
Fig. 5
Fig. 5
RASP and other common options for BPH surgical treatment
See this image and copyright information in PMC

References

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