Urethral-sparing robotic-assisted prostatectomy improves the outcomes of patients with benign prostatic hyperplasia

This study investigated the effectiveness of urethral-sparing robotic-assisted prostate surgery (USRAP) in the treatment of benign prostatic hyperplasia (BPH). Researchers suggested that USRAP is a good and safe method for the treatment of these patients.

Prostatic hyperplasia consists of an enlarged prostate that results in urinary symptoms. It is a common disorder in men over 50 years of age. Conventional open surgery is the standard treatment. However, in recent years, less invasive methods have been developed.

Robotic-assisted prostate surgery consists of using robotic hands to perform prostate removal surgery with more precision. Patients who undergo this surgery commonly have less blood loss and shorter hospital stays. However, impaired ejaculation is seen in some patients. This affects the quality of life of patients. Prior studies showed that surgery that spares the urethra (urinary tube) prevents this side effect. However, the effectiveness of USRAP in patients with an enlarged prostate is still not clear.

This study included information about 92 patients with BPH and urinary symptoms who received robotic-assisted prostate surgery (RAP). Patients had prostates larger than 80 ml. 

Full USRAP was performed in 56 patients (60.86%). A minimal urethral change during surgery was done in 21 patients (22.82%). In 15 patients (16.48%), the USRAP was changed to standard RAP.

After an average follow-up of 12 months, no significant impact on sexual function was seen. Among patients with normal ejaculation function before the surgery, 81% had preserved ejaculation function. USRAP was associated with an improvement in terms of ejaculation at 3 months. The urinary function was improved after surgery. No patients had urine leakage at any time point after surgery.

This study concluded that USRAP improves urinary symptoms with fewer side effects in patients with an enlarged prostate.

This study included a limited number of participants and had a short follow-up time. Further studies with bigger populations and extended follow-up are necessary.