LBA01-08 PROSPECTIVE MULTI-INSTITUTIONAL ANALYSIS OF SINGLE PORT SIMPLE PROSTATECTOMY OUTCOMES

Abstract

INTRODUCTION AND OBJECTIVE: The treatment of large gland benign prostatic hyperplasia (BPH) can pose significant surgical challenges. Current treatment guidelines recommend consideration of laser enucleation, open, and robotic assisted approaches for glands over 80 grams. The da Vinci Single Port robot offers a less invasive approach as compared to the multiport robotic assisted simple prostatectomy. We prospectively assessed surgical, functional, and quality of life (QoL) outcomes of single port robotic assisted simple prostatectomy (SP RASP) in a multi-institutional setting. METHODS: A prospective study was conducted from January 2020 to May 2021 of men that underwent SP RASP at two separate institutions. Two surgeons with extensive robotic experience performed the procedures. Patient demographic characteristics were collected. Pre and postoperative characteristics evaluated were post void residual (PVR), International Prostate Symptom Score (IPSS), PSA, days with catheter, continence, and length of follow up. Intraoperative data included operative times, specimen dry weight and pathology, and estimated blood loss (EBL). RESULTS: A total of 51 SP RASPs were performed. Mean age and BMI was 69.5 kg and 25.7 kg/m2. Mean preoperative PVR was 227.9 ml, IPSS 23.2. Mean operative time was 172.2 min, specimen dry weight was 91.4 gm, EBL was 209.7 ml. Pathology was benign prostatic hyperplasia in 48 patients. Prostate cancer was incidentally noted in three patients (GG1, GG2, and GG3 respectively). Mean postoperative catheterization was 7 days. Mean postoperative IPSS and PVR were 5.78 and 25.1 ml. A total of 5 patients developed de novo urge urinary incontinence. No patients reported stress urinary incontinence. Mean follow up was 7.4 months. CONCLUSIONS: The single incision, transvesical approach of the SP RASP offers a minimally invasive option for the treatment of large gland BPH. Postoperative continence rates, significant decrease in IPSS and PVR are viewed as significant advantages to this procedure. We suspect that the excellent postoperative continence rates may be due to the bladder neck reconstruction allowed by this approach.