Urethral Sparing versus Trans-Vesical Robot-Assisted Simple Prostatectomy: A Comparative Analysis of Perioperative, Postoperative Outcomes, and Ejaculation Preservation.

Autor:	Shin YS; Department of Urology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea., Pak SW; Department of Urology, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea., Hwang W; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Jo SB; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Kim JW; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Oh MM; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Park HS; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Moon DG; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea., Ahn ST; Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. asturology@gmail.com.
Jazyk:	angličtina
Zdroj:	The world journal of men's health [World J Mens Health] 2024 May 30. Date of Electronic Publication: 2024 May 30.
DOI:	10.5534/wjmh.240023
Abstrakt:	Purpose: To compare the perioperative and postoperative outcomes between traditional trans-vesical robot-assisted simple prostatectomy (TV-RASP) and the newly introduced urethral-sparing (US) RASP. Materials and Methods: We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation. Results: This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001). Conclusions: US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP. Competing Interests: The authors have nothing to disclose. (Copyright © 2024 Korean Society for Sexual Medicine and Andrology.)
Databáze:	MEDLINE
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