Choi Sae Woong, Sohn Dong Wan, Ha U-Syn, Hong Sung-Hoo, Lee Ji Youl, Cho Hyuk Jin
Department of Urology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea.
Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Clin Med. 2023 Jul 24;12(14):4867. doi: 10.3390/jcm12144867.
We report a comparative analysis of extraperitoneal urethra-sparing robot-assisted simple prostatectomy (EUS-RASP) versus robot-assisted simple prostatectomy (RASP) using the Freyer approach for patients with a large prostate volume greater than 80 mL.
A total of 32 patients underwent EUS-RASP, and 30 underwent RASP from April 2018 to November 2021. All the perioperative data and 6-month follow-up data were collected prospectively. We retrospectively evaluated baseline characteristics and functional outcomes, including International Prostate Symptom Scores (IPSSs) and quality of life (QOL), maximum flow rate, and post-void residual volume, between the two groups. Sexual function was analyzed in the EUS-RASP group.
The patients undergoing EUS-RASP and RASP had comparable baseline characteristics and functional outcomes. The EUS-RASP group showed a shorter operative time (123.4 ± 15.2 min vs. 133.7 ± 21.4 min, = 0.034), length of hospital stay (2.9 ± 1.5 days vs. 4.6 ± 1.5 days, = 0.001), and catheterization time (2.4 ± 1.7 days vs. 8.1 ± 2.4 days, < 0.001). A total of 14/32 (43.8%) patients reported normal preoperative ejaculatory function in the EUS-RASP group, and 11/14 (78.6%) maintained antegrade ejaculation postoperatively.
Extraperitoneal urethra-sparing RASP is an effective and feasible procedure that can improve voiding function and allow for the maintenance of ejaculatory function in patients with large prostates.
我们报告了一项针对前列腺体积大于80 mL的患者，采用弗赖尔入路的腹膜外保留尿道机器人辅助单纯前列腺切除术（EUS-RASP）与机器人辅助单纯前列腺切除术（RASP）的对比分析。
2018年4月至2021年11月期间，共有32例患者接受了EUS-RASP，30例接受了RASP。前瞻性收集所有围手术期数据和6个月的随访数据。我们回顾性评估了两组患者的基线特征和功能结局，包括国际前列腺症状评分（IPSS）和生活质量（QOL）、最大尿流率和残余尿量。对EUS-RASP组的性功能进行了分析。
接受EUS-RASP和RASP的患者具有可比的基线特征和功能结局。EUS-RASP组的手术时间更短（123.4±15.2分钟对vs . 133.7±21.4分钟，P = 0.034），住院时间更短（2.9±1.5天对vs . 4.6±1.5天，P = 0.001），导尿时间更短（2.4±1.7天对vs . 8.1±2.4天，P<0.001）。EUS-RASP组共有14/32（43.8%）的患者术前射精功能正常，其中11/14（78.6%）术后保持顺行射精。
腹膜外保留尿道机器人辅助单纯前列腺切除术是一种有效且可行的手术方法，可改善大前列腺患者的排尿功能并维持射精功能。
