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Current Urology Reports
Published in: Current Urology Reports 10/2014

01-10-2014 | Benign Prostatic Hyperplasia (K McVary, Section Editor)

Robotic-Assisted Simple Prostatectomy: Is there Evidence to go Beyond the Experimental Stage?

Authors: Nishant D. Patel, J. Kellogg Parsons

Published in: Current Urology Reports | Issue 10/2014

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Abstract

Open simple prostatectomy (OSP) is an effective and durable treatment for select patients with symptomatic benign prostatic hyperplasia (BPH) and large-volume prostate glands (>80 cc), yet is associated with clinically significant risk of bleeding, transfusion, prolonged hospital length of stay (LOS), and complications. Robotic-assisted simple prostatectomy (RASP) potentially reduces intraoperative blood loss and improves perioperative outcomes. Thirteen non-comparative series (Level 3 evidence) of RASP have established its safety and efficacy and have demonstrated substantially decreased risk of transfusion, complications, and mean LOS relative to published series of OSP, but with consistently longer operative times. Comparative outcomes data (Level 1 and Level 2 evidence), however, are relatively lacking. Thus, while RASP has advanced beyond the experimental stage, definitive outcomes studies are needed to establish its benefits and costs relative to OSP and transurethral surgery.
Literature
1.
Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. J Urol. 2008;179:S75–80.PubMedCrossRef
2.
Irwin DE, Kopp ZS, Agatep B, et al. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011;108:1132–8.PubMedCrossRef
3.
Kupelian V, Fitzgerald MP, Kaplan SA, et al. Association of nocturia and mortality: results from the Third National Health and Nutrition Examination Survey. J Urol. 2011;185:571–7.PubMedCrossRef
4.
Groves HK, Chang D, Palazzi K, et al. The incidence of acute urinary retention secondary to BPH is increasing among California men. Prostate Cancer Prostatic Dis. 2013;16:260–5.PubMedCrossRef
5.
Stroup SP, Palazzi-Churas K, Kopp RP, et al. Trends in adverse events of benign prostatic hyperplasia (BPH) in the USA, 1998 to 2008. BJU Int. 2012;109:84–7.PubMedCrossRef
6.
McVary KT, Roehrborn CG, Avins AL, et al. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011;185:1793–803.PubMedCrossRef
7.
Serretta V, Morgia G, Fondacaro L, et al. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology. 2002;60:623–7.PubMedCrossRef
8.
de la Rosette JJ, Alivizatos G, Madersbacher S, et al. EAU Guidelines on benign prostatic hyperplasia (BPH). Eur Urol. 2001;40:256–63. discussion 264.PubMedCrossRef
9.
Ou R, You M, Tang P, et al. A randomized trial of transvesical prostatectomy versus transurethral resection of the prostate for prostate greater than 80 mL. Urology. 2010;76:958–61.PubMedCrossRef
10.
Ngugi PM, Saula PW. Open simple prostatectomy and blood transfusion in Nairobi. East Afr Med J. 2007;84:S12–23.PubMed
11.
Suer E, Gokce I, Yaman O, et al. Open prostatectomy is still a valid option for large prostates: a high-volume, single-center experience. Urology. 2008;72:90–4.PubMedCrossRef
12.
Varkarakis I, Kyriakakis Z, Delis A, et al. Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology. 2004;64:306–10.PubMedCrossRef
13.
Rangaragan S, Palazzi K, Parsons JK. Comparative outcomes of open and minimally invasive simple prostatectomy for symptomatic benign prostatic hyperplasia. J Urol Suppl. 2014;191:e789.CrossRef
14.
Mirheydar HS, Parsons JK. Diffusion of robotics into clinical practice in the United States: process, patient safety, learning curves, and the public health. World J Urol. 2013;31:455–61.PubMedCrossRef
15.
McVary KT, Roerhborn CG, Alvins AL et al. American Urological Association Guideline: Management of Benign Prostatic Hyperplasia. 2010. p. 18–19.
16.
Mariano MB, Graziottin TM, Tefilli MV. Laparoscopic prostatectomy with vascular control for benign prostatic hyperplasia. J Urol. 2002;167:2528–9.PubMedCrossRef
17.
Mariano MB, Tefilli MV, Graziottin TM, et al. Laparoscopic prostatectomy for benign prostatic hyperplasia–a six-year experience. Eur Urol. 2006;49:127–31. discussion 131.PubMedCrossRef
18.
Sotelo R, Spaliviero M, Garcia-Segui A, et al. Laparoscopic retropubic simple prostatectomy. J Urol. 2005;173:757–60.PubMedCrossRef
19.
Baumert H, Ballaro A, Dugardin F, et al. Laparoscopic versus open simple prostatectomy: a comparative study. J Urol. 2006;175:1691–4.PubMedCrossRef
20.
Barret E, Bracq A, Braud G, et al. The morbidity of laparoscopic versus open simple prostatectomy. Eur Urol. 2006;49:120.CrossRef
21.
22.
Yuh B, Laungani R, Perlmutter A, et al. Robot-assisted Millin’s retropubic prostatectomy: case series. Can J Urol. 2008;15:4101–5.PubMed
23.
John H, Bucher C, Engel N, et al. Preperitoneal robotic prostate adenomectomy. Urology. 2009;73:811–5.PubMedCrossRef
24.
Joseph JV, Rosenbaum R, Madeb R, et al. Robotic extraperitoneal radical prostatectomy: an alternative approach. J Urol. 2006;175:945–50. discussion 951.PubMedCrossRef
25.••
Matei DV, Brescia A, Mazzoleni F, et al. Robot-assisted simple prostatectomy (RASP): does it make sense? BJU Int. 2012;110:E972–9. With 35 patients included, this is the largest case series of RASP. The authors report a 0 % rate of transfusion, and they present data on the learning curve of RASP at their institution as well as a cost analysis of the procedure compared to OSP and TURP.PubMedCrossRef
26.••
Banapour P, Patel N, Kane CJ, et al. Robotic-assisted simple prostatectomy: a systematic review and report of a single institution case series. Prostate Cancer Prostatic Dis. 2014;17:1–5. This systematic review presents all prior published series of RASP, as well as the authors’ own institutional data comparing transvesical versus transcapsular RASP.PubMedCrossRef
27.
Leslie S, de Castro Abreu AL, Chopra S et al. Transvesical Robotic Simple Prostatectomy: Initial Clinical Experience. Eur Urol. 2014.
28.
Uffort E, Jensen J. Robotic-assisted laparoscopic simple prostatectomy: an alternative minimal invasive approach for prostate adenoma. J Robot Surg. 2010;4:7–10.CrossRef
29.
Matei DV, Spinelli M, Nordio A, et al. Robotic simple prostatectomy. Eur Urol Suppl. 2010;9:337.CrossRef
30.
Sutherland DE, Perez DS, Weeks DC. Robot-assisted simple prostatectomy for severe benign prostatic hyperplasia. J Endourol. 2011;25:641–4.PubMedCrossRef
31.
Vora A, Mittal S, Hwang J, et al. Robot-assisted simple prostatectomy: multi-institutional outcomes for glands larger than 100 grams. J Endourol. 2012;26:499–502.PubMedCrossRef
32.
Fareed K, Zaytoun OM, Autorino R, et al. Robotic single port suprapubic transvesical enucleation of the prostate (R-STEP): initial experience. BJU Int. 2012;110:732–7.PubMedCrossRef
33.
Coelho RF, Chauhan S, Sivaraman A, et al. Modified technique of robotic-assisted simple prostatectomy: advantages of a vesico-urethral anastomosis. BJU Int. 2012;109:426–33.PubMedCrossRef
34.
Clavijo R, Carmona O, De Andrade R, et al. Robot-assisted intrafascial simple prostatectomy: novel technique. J Endourol. 2013;27:328–32.PubMedCrossRef
35.
Geavlete B, Stanescu F, Iacoboaie C, et al. Bipolar plasma enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases – a medium term, prospective, randomized comparison. BJU Int. 2013;111:793–803.PubMedCrossRef
36.
Skolarikos A, Papachristou C, Athanasiadis G, et al. Eighteen-month results of a randomized prospective study comparing transurethral photoselective vaporization with transvesical open enucleation for prostatic adenomas greater than 80 cc. J Endourol. 2008;22:2333–40.PubMedCrossRef
37.
Tubaro A, Carter S, Hind A, et al. A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol. 2001;166:172–6.PubMedCrossRef
Metadata
Title
Robotic-Assisted Simple Prostatectomy: Is there Evidence to go Beyond the Experimental Stage?
Authors
Nishant D. Patel
J. Kellogg Parsons
Publication date
01-10-2014
Publisher
Springer US
Published in
Current Urology Reports / Issue 10/2014
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-014-0443-0

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