Department of Urology, Indiana University School of Medicine, 1801 North Senate Blvd., Indianapolis, IN, 46202, USA.
Indiana University School of Medicine, Indianapolis, USA.
Curr Urol Rep. 2023 May;24(5):221-229. doi: 10.1007/s11934-023-01146-9. Epub 2023 Feb 17.
This study reviews contemporary literature on RASP and HoLEP to evaluate perioperative outcomes, common complications, cost analytics, and future directions of both procedures.
RASP is indicated for prostates > 80 mL, while HoLEP is size-independent. No notable differences were found in operative time, PSA nadir (surrogate for enucleation volume), re-catheterization rates, or long-term durability. Prolonged incontinence and bladder neck contracture rates are low for both surgeries. Patients experience similar satisfaction outcomes and improvements in uroflowmetry and post-void residual volumes. HoLEP demonstrates shorter hospitalizations, lower transfusion rates, lower costs, and higher rates of same-day discharge. RASP offers a shorter learning curve and lower rates of early postoperative urinary incontinence. HoLEP is a size-independent surgery that offers advantages for patients seeking a minimally invasive procedure with the potential for catheter-free same-day discharge. Future directions with single-port simple prostatectomy may offer parity in same-day discharge, but further research is needed to determine broader feasibility.
本研究回顾了 RASP 和 HoLEP 的当代文献，以评估这两种手术的围手术期结果、常见并发症、成本分析和未来方向。
RASP 适用于前列腺体积＞80ml，而 HoLEP 则与体积无关。在手术时间、PSA 最低值（去势体积的替代指标）、再置管率或长期耐久性方面，两种手术均无显著差异。两种手术的尿失禁和膀胱颈挛缩发生率均较低。患者在尿流率和残余尿量方面的满意度和改善情况相似。HoLEP 具有较短的住院时间、较低的输血率、较低的成本和更高的当日出院率。RASP 具有较短的学习曲线和较低的早期术后尿失禁发生率。HoLEP 是一种与体积无关的手术，为寻求微创、有潜力实现无导尿管当日出院的患者提供了优势。单端口简单前列腺切除术的未来发展方向可能在当日出院方面具有同等地位，但需要进一步研究来确定更广泛的可行性。
