Andrea Fuschi1,2, Yazan Al Salhi1,2, Gennaro Velotti1, Lorenzo Capone1, Alessia Martoccia1, Paolo P Suraci1, Silvio Scalzo1, Filippo Annino3, Saba Khorrami3, Anastasios Asimakopoulos4, Giorgio Bozzini5, Mario Falsaperla6, Antonio Carbone1,7, Antonio L Pastore8,7. 1. Unit of Urology, Department of Medical, Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University, Latina, Italy. 2. ICOT - Surgery, Orthopedy, Traumatology Institute, Latina, Italy. 3. Unit of Urology, San Donato Hospital, Arezzo, Italy. 4. Unit of Urology, Tor Vergata Polyclinic, Rome, Italy. 5. Unit of Urology, Department of Urology, ASST Valle Olona, Busto Arsizio, Varese, Italy. 6. Unit of Urology, ARNAS Garibaldi Hospital, Catania, Italy. 7. Uroresearch, Non-Profit Urology Research Association, Latina, Italy. 8. Unit of Urology, Department of Medical, Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University, Latina, Italy - antopast@hotmail.com.
Abstract
BACKGROUND: The aim of this study was to compare the perioperative and functional results between laparoscopic and robot-assisted simple prostatectomy (LSP and RASP) and Holmium laser enucleation of prostate (HoLEP) in prostate volumes ≥120 mL. The primary endpoint was to investigate and compare minimally invasive techniques in the management of large prostate gland volume, and the secondary endpoint was to evaluate the frequency and type of postoperative complications according to Clavien Dindo Classification. METHODS: This multicenter study was conducted on male patients with LUTS associated with BPO candidates for surgical treatment. The surgery approach choice in relation to the prostatic volume ≥120 mL was HoLEP or minimally-invasive simple prostatectomy (LSP or RASP). All patients were prospectively randomized into three groups, according to a simple computed randomization: HoLEP, LSP and RASP groups. During the follow-up, all patients underwent postoperative control at 1, 3, 6, 12 and 24 months from the surgical procedure. RESULTS: One hundred ten male patients were randomized in three homogeneous groups: 36 in LSP, 32 in RASP and 42 in HoLEP group. During the follow-up (mean 26.15 months), despite the significant improvement compared to baseline results, no significant differences were shown, between the groups in terms of functional and perioperative outcomes. The only statistically significant data was reported for catheterization time, that resulted longer in the LSP group than RASP and HoLEP groups (P=0.002). Furthermore, MISP resulted in longer hospitalization, and lower rate of patients with new-onset irritative symptoms. CONCLUSIONS: This prospective randomized study is the first to compare extraperitoneal LSP, RASP and HoLEP in the treatment of LUTS secondary to benign prostatic hyperplasia for prostate volumes ≥120 mL. Our findings confirm the safety and efficacy of MISP, demonstrating its equivalence in functional outcomes and perioperative morbidity in comparison to HoLEP.
BACKGROUND: The aim of this study was to compare the perioperative and functional results between laparoscopic and robot-assisted simple prostatectomy (LSP and RASP) and Holmium laser enucleation of prostate (HoLEP) in prostate volumes ≥120 mL. The primary endpoint was to investigate and compare minimally invasive techniques in the management of large prostate gland volume, and the secondary endpoint was to evaluate the frequency and type of postoperative complications according to Clavien Dindo Classification. METHODS: This multicenter study was conducted on male patients with LUTS associated with BPO candidates for surgical treatment. The surgery approach choice in relation to the prostatic volume ≥120 mL was HoLEP or minimally-invasive simple prostatectomy (LSP or RASP). All patients were prospectively randomized into three groups, according to a simple computed randomization: HoLEP, LSP and RASP groups. During the follow-up, all patients underwent postoperative control at 1, 3, 6, 12 and 24 months from the surgical procedure. RESULTS: One hundred ten male patients were randomized in three homogeneous groups: 36 in LSP, 32 in RASP and 42 in HoLEP group. During the follow-up (mean 26.15 months), despite the significant improvement compared to baseline results, no significant differences were shown, between the groups in terms of functional and perioperative outcomes. The only statistically significant data was reported for catheterization time, that resulted longer in the LSP group than RASP and HoLEP groups (P=0.002). Furthermore, MISP resulted in longer hospitalization, and lower rate of patients with new-onset irritative symptoms. CONCLUSIONS: This prospective randomized study is the first to compare extraperitoneal LSP, RASP and HoLEP in the treatment of LUTS secondary to benign prostatic hyperplasia for prostate volumes ≥120 mL. Our findings confirm the safety and efficacy of MISP, demonstrating its equivalence in functional outcomes and perioperative morbidity in comparison to HoLEP.
Authors: Dor Golomb; Fernanda Gabrigna Berto; Jennifer Bjazevic; Jose A Gomez; Joseph L K Chin; Patrick P Luke; Stephen E Pautler Journal: Can Urol Assoc J Date: 2021-08-26 Impact factor: 1.862
Authors: Mohammad Hout; Aaron Gurayah; Maria Camila Suarez Arbelaez; Ruben Blachman-Braun; Khushi Shah; Thomas R W Herrmann; Hemendra N Shah Journal: World J Urol Date: 2022-10-04 Impact factor: 3.661
Authors: Mehmet Yilmaz; Mustafa Karaaslan; Halil Cagri Aybal; Maximilian Ferry von Bargen; Senol Tonyali; Tuncay Toprak; Christian Gratzke; Arkadiusz Miernik Journal: Ann Med Surg (Lond) Date: 2022-07-31