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Robotic-assisted simple prostatectomy: a systematic review and report of a single institution case series

Prostate Cancer and Prostatic Diseases volume 17, pages 1–5 (2014)Cite this article

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Abstract

Open simple prostatectomy (OSP) is an effective treatment for patients with symptomatic BPH and larger volume prostates; however, it is associated with substantial risks of bleeding, transfusion and prolonged hospital length of stay (LOS). Robotic-assisted simple prostatectomy (RASP) potentially offers improved perioperative outcomes for these patients. We systematically reviewed published data on RASP outcomes and analyzed our experience at the University of California San Diego (UCSD). We identified eight published studies, all non-comparative case series (Level 3 evidence), reporting a total of 109 RASP cases from 2008 to 2012. Indications included acute urinary retention (n=48), persistent obstructive symptoms (n=51), failure of medical management (n=9) and recurrent urinary tract infections (n=2). The mean ages ranged from 65 to 77 years. More than 75% of the studies reported a mean LOS <3 days and a transfusion prevalence of 0%. The mean resected prostate weights ranged from 51 to 301 g. For UCSD, indications for surgery included urinary retention (n=11) and failure of medical management (n=5). The mean age was 68 years, transfusion prevalence 0%, mean resected prostate weight 94 g and mean LOS 1 day. All nine series observed substantial postoperative improvements in urinary symptoms and retention. These data suggest that RASP is a safe and efficacious treatment for BPH in select patients with larger prostates. Although LOS and transfusion prevalence for RASP are markedly lower than the published OSP series, comparative studies are needed to verify these results.

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References

  1. Wei JT, Calhoun E, Jacobsen SJ . Urologic diseases in america project: benign prostatic hyperplasia. J Urol 2008; 179: S75–S80.

    PubMed  Google Scholar 

  2. Kupelian V, Wei JT, O’Leary MP, Kusek JW, Litman HJ, Link CL et al. Prevalence of lower urinary tract symptoms and effect on quality of life in a racially and ethnically diverse random sample: the Boston Area Community Health (BACH) Survey. Arch Intern Med 2006; 166: 2381–2387.

    Article  PubMed  Google Scholar 

  3. Jacobsen SJ, Girman CJ, Guess HA, Rhodes T, Oesterling JE, Lieber MM . Natural history of prostatism: longitudinal changes in voiding symptoms in community dwelling men. J Urol 1996; 155: 595–600.

    Article  CAS  PubMed  Google Scholar 

  4. Parsons JK, Bergstrom J, Silberstein J, Barrett-Connor E . Prevalence and characteristics of lower urinary tract symptoms in men aged&gt;or=80 years. Urology 2008; 72: 318–321.

    Article  PubMed  Google Scholar 

  5. Parsons JK . Benign prostatic hyperplasia and male lower urinary tract symptoms: epidemiology and risk factors. Curr Bladder Dysfunct Rep 2010; 5: 212–218.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Parsons JK, Wilt TJ, Wang PY, Barrett-Connor E, Bauer DC, Marshall LM . Progression of lower urinary tract symptoms in older men: a community based study. J Urol 2010; 183: 1915–1920.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Taylor BC, Wilt TJ, Fink HA, Lambert LC, Marshall LM, Hoffman AR et al. Prevalence, severity, and health correlates of lower urinary tract symptoms among older men: the MrOS study. Urology 2006; 68: 804–809.

    Article  PubMed  Google Scholar 

  8. Groves HK, Chang D, Palazzi K, Cohen S, Parsons JK . The incidence of acute urinary retention secondary to BPH is increasing among California men. Prostate Cancer Prostatic Dis 2013; 16: 260–265.

    Article  CAS  PubMed  Google Scholar 

  9. Stroup SP, Palazzi-Churas K, Kopp RP, Parsons JK . Trends in adverse events of benign prostatic hyperplasia (BPH) in the USA, 1998 to 2008. BJU Int 2012; 109: 84–87.

    Article  PubMed  Google Scholar 

  10. Saigal CS, Joyce G . Economic costs of benign prostatic hyperplasia in the private sector. J Urol 2005; 173: 1309–1313.

    Article  PubMed  Google Scholar 

  11. McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol 2011; 185: 1793–1803.

    Article  PubMed  Google Scholar 

  12. Serretta V, Morgia G, Fondacaro L, Curto G, Lo bianco A, Pirritano D et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990 s: a contemporary series of 1800 interventions. Urology 2002; 60: 623–627.

    Article  PubMed  Google Scholar 

  13. Mearini E, Marzi M, Mearini L, Zucchi A, Porena M . Open prostatectomy in benign prostatic hyperplasia: 10-year experience in Italy. Eur Urol 1998; 34: 480–485.

    Article  CAS  PubMed  Google Scholar 

  14. de la Rosette JJ, Alivizatos G, Madersbacher S, Perachino M, Thomas D, Desgrandchamps F et al. EAU Guidelines on benign prostatic hyperplasia (BPH). Eur Urol 2001; 40: 256–263.

    Article  CAS  PubMed  Google Scholar 

  15. Ou R, You M, Tang P, Chen H, Deng X, Xie K . A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. Urology 2010; 76: 958–961.

    Article  PubMed  Google Scholar 

  16. Ahmed Gadam I, Nuhu A, Aliyu S . Ten-year experience with open prostatectomy in maiduguri. ISRN Urol 2012; 2012: 406872.

    PubMed  PubMed Central  Google Scholar 

  17. Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N et al. Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol 2007; 177: 1419–1422.

    Article  PubMed  Google Scholar 

  18. Ngugi PM, Saula PW . Open simple prostatectomy and blood transfusion in Nairobi. East Afr Med J 2007; 84: S12–S23.

    CAS  PubMed  Google Scholar 

  19. Suer E, Gokce I, Yaman O, Anafarta K, Gogus O . Open prostatectomy is still a valid option for large prostates: a high-volume, single-center experience. Urology 2008; 72: 90–94.

    Article  PubMed  Google Scholar 

  20. Varkarakis I, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C . Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 2004; 64: 306–310.

    Article  PubMed  Google Scholar 

  21. Sotelo R, Clavijo R, Carmona O, Garcia A, Banda E, Miranda M et al. Robotic simple prostatectomy. J Urol 2008; 179: 513–515.

    Article  PubMed  Google Scholar 

  22. John H, Bucher C, Engel N, Fischer B, Fehr JL . Preperitoneal robotic prostate adenomectomy. Urology 2009; 73: 811–815.

    Article  PubMed  Google Scholar 

  23. Matei DV, Spinelli M, Nordio A, Brescia A, Crisan N, Coman I . Robotic simple prostatectomy. Eur Urol Suppl 2008; 9: 337.

    Article  Google Scholar 

  24. Matei DV, Brescia A, Mazzoleni F, Spinelli M, Musi G, Melegari S et al. Robot-assisted simple prostatectomy (RASP): does it make sense? BJU Int 2012; 110: E972–E979.

    Article  PubMed  Google Scholar 

  25. Sutherland DE, Perez DS, Weeks DC . Robot-assisted simple prostatectomy for severe benign prostatic hyperplasia. J Endourol 2011; 25: 641–644.

    Article  PubMed  Google Scholar 

  26. Uffort E, Jensen J . Robotic-assisted laparoscopic simple prostatectomy: an alternative minimal invasive approach for prostate adenoma. J Robot Surg 2010; 4: 7–10.

    Article  PubMed  Google Scholar 

  27. Vora A, Mittal S, Hwang J, Bandi G . Robot-assisted simple prostatectomy: multi-institutional outcomes for glands larger than 100 grams. J Endourol 2012; 26: 499–502.

    Article  PubMed  Google Scholar 

  28. Yuh B, Laungani R, Perlmutter A, Eun D, Peabody JO, Mohler JL et al. Robot-assisted Millin’s retropubic prostatectomy: case series. Can J Urol 2008; 15: 4101–4105.

    PubMed  Google Scholar 

  29. Zargooshi J . Open prostatectomy for benign prostate hyperplasia: short-term outcome in 3000 consecutive patients. Prostate Cancer Prostatic Dis 2007; 10: 374–377.

    Article  CAS  PubMed  Google Scholar 

  30. Baumert H, Ballaro A, Dugardin F, Kaisary AV . Laparoscopic versus open simple prostatectomy: a comparative study. J Urol 2006; 175: 1691–1694.

    Article  CAS  PubMed  Google Scholar 

  31. McCullough TC, Heldwein FL, Soon SJ, Galiano M, Barret E, Cathelineau X et al. Laparoscopic versus open simple prostatectomy: an evaluation of morbidity. J Endourol 2009; 23: 129–133.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. San Diego School of Medicine, University of California, CA, La Jolla, USA

    P Banapour, N Patel, C J Kane, S A Cohen & J K Parsons

  2. Department of Urology, University of California San Diego Health System, CA, San Diego, USA

    N Patel, C J Kane, S A Cohen & J K Parsons

  3. Division of Urologic Oncology, University of California San Diego Moores Cancer Center, CA, La Jolla, USA

    C J Kane & J K Parsons

  4. Section of Urology, Veterans Affairs San Diego Healthcare System, CA, San Diego, USA

    C J Kane & J K Parsons

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  1. P Banapour
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Correspondence to J K Parsons.

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Competing interests

Dr Kane is a consultant or has received honoraria from Amgen Inc, Janssen Inc, Dendreon Inc and Intuitive Inc. Dr J Kellogg Parsons is a speaker for American Medical Systems and a consultant for Sophiris and Watson. The remaining authors declare no conflict of interest.

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Banapour, P., Patel, N., Kane, C. et al. Robotic-assisted simple prostatectomy: a systematic review and report of a single institution case series. Prostate Cancer Prostatic Dis 17, 1–5 (2014). https://doi.org/10.1038/pcan.2013.52

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