Surgical treatment of large volume prostates: a matched pair analysis comparing the open, endoscopic (ThuVEP) and robotic approach

Nestler, Sebastian; Bach, Thorsten; Herrmann, Thomas; Jutzi, S.; Roos, Frederik C.; Hampel, Christian; Thüroff, Joachim W.; Thomas, Christian; Neisius, Andreas

doi:10.1007/s00345-018-2585-z

Cited by 35 publications

(42 citation statements)

References 22 publications

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“…Probably endoscopic procedures are less invasive when compared to laparoscopy, considering that patient has no need of general anesthesia and has shorter catheterization time. However, in very large prostates (> 200 cc), endoscopy may be challenging and time consuming [18]. In our experience, both techniques showed good functional outcomes and safety profiles at three years.…”

Section: Discussionmentioning

confidence: 64%

Laparoscopic simple prostatectomy vs bipolar plasma enucleation of the prostate in large benign prostatic hyperplasia: a two-center 3-year comparison

Lombardo¹,

Andraca

Alonso

et al. 2020

World J Urol

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Purpose To compare surgery outcomes and safety of button bipolar enucleation of the prostate vs laparoscopic simple prostatectomy in patients with large prostates (> 80 g) in a two-center cohort study. Methods All patients with lower urinary tract symptoms due to benign prostatic enlargement (Prostate volume > 80 cc) undergoing button bipolar enucleation of the prostate (BTUEP) or laparoscopic simple prostatectomy (LSP) in two centers were enrolled. Data on clinical history, physical examination, urinary symptoms, uroflowmetry and prostate volume were collected at 0, 1, 3 6, 12, 24 and 36 months. Early and long-term complications were recorded. Results Overall, 296 patients were enrolled. Out of them, 167/296 (56%) performed a LSP and 129/296 (44%) performed a BTUEP. In terms of efficacy both procedures showed durable results at three years with a reintervention rate of 8% in the LSP group and of 5% in the BTUEP group. In terms of safety, BTUEP and LSP presented similar safety profiles with a 9% of transfusion rate and no major complications. Conclusion LSP and BTUEP are safe and effective in treating large-volume adenomas with durable results at three years when performed in experienced centers.

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Section: Discussionmentioning

confidence: 64%

Laparoscopic simple prostatectomy vs bipolar plasma enucleation of the prostate in large benign prostatic hyperplasia: a two-center 3-year comparison

Lombardo¹,

Andraca

Alonso

et al. 2020

World J Urol

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“…For HoLEP, the conventional Gilling technique was used. The summary of the preoperative parameters for the different studies are listed in Table 1 [1, [14][15][16][17][18].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Minimally invasive simple prostatectomy in the era of laser enucleation for high-volume prostates: A systematic review and meta-analysis

Chebel

Sarkis

Helou

et al. 2020

Arab Journal of Urology

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Objective: To perform a systematic review and meta-analysis of available prospective and retrospective studies comparing the minimally invasive (laparoscopic or robot-assisted) simple prostatectomy (MISP) and laser enucleation of the prostate for treating male lower urinary tract symptoms in high-volume prostates, as laser enucleation of the prostate is the new trend for treating high-volume prostates (>80 mL) but many urologists now prefer MISP. Methods: A systematic search was done using the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cochrane databases in June 2019, with research terms including: 'laser', 'laparoscopy', 'enucleation', 'BPH', 'simple prostatectomy', 'Millins', and 'adenomectomy'. The meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Of 38 screened articles, six were analysed and a total of 975 men were included. The average operative time, length of stay and catheterisation time were significantly shorter in the laser enucleation group (P = 0.006, P < 0.001 and P < 0.001, respectively). The amount of prostatic tissue removed during surgery was comparable between both the laser enucleation and MISP groups (P = 0.39). The International Prostate Symptom Score, prostate-specific antigen level, maximum urinary flow rate and post-void residual urine volume were also comparable at 3 months. Finally, similar transfusion rates and Clavien-Dindo complication rates were observed (P = 0.08 and P = 0.41, respectively). Conclusion: This systematic review of the literature and meta-analysis provide a further demonstration of the safety and effectiveness of both laser enucleation and MISP. While laser enucleation had a shorter catheterisation time and hospital stay than MISP, the latter still had unique and specific indications. Abbreviations: ELEP: eraser laser enucleation of the prostate; HoLEP: holmium laser enucleation of the prostate; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PVR: post-void residual urine volume; Q max : maximum urinary flow rate; (L)(MI)(RA)SP: (laparoscopic) (minimally-invasive) (robot-assisted) simple prostatectomy ARTICLE HISTORY

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“…Urinary incontinence (UI) was reported in eight studies [15,[21][22][23]34,38,40,44]. Although Nestler et al [44] reported UI in nine out of 35 RASP patients (25.7%), Elsamra et al [23] in three out of 15 patients (20%), and Steinberg et al [34] in one out of 10 patients (10%), in other series UI was less than 5.5% and mostly around 1%. However, these UI rates are early UI rates with less than a 3-month follow-up.…”

Section: Resultsmentioning

confidence: 99%

“…There are four studies comparing RASP outcomes to OSP [36,[42][43][44][45] (Table 2). In all of these studies, the length of operation was significantly longer in RASP compared to OSP.…”

Section: Resultsmentioning

confidence: 99%

Robotic-Assisted Simple Prostatectomy: A Systematic Review

Kordan

Canda

Köseoğlu

et al. 2020

JCM

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Contemporary minimally invasive surgical (MIS) treatment options of patients with male Lower Urinary Tract Symptoms (LUTS) in men with prostate glands >80 mL include Holmium Laser Enucleation Prostate (HoLEP), Thulium laser VapoEnucleation Prostate (ThuVEP), and Laparoscopic (LSP) or Robotic-Assisted Simple Prostatectomy (RASP). Implementing new laser technologies is costly, and the steep learning curve of these laser techniques limit their wide range use. This promoted the use of LSP and RASP in centers with readily established laparoscopy or robotic surgery programs. The aim of this study is to review case and comparative series of RASP. We systematically reviewed published data from 2008 to 2020 on RASP and have identified 26 non-comparative and 9 comparative case series. RASP has longer operation time but less time spent in hospital and less blood loss. The outcomes of improvements in symptom score, post-voiding residual urine (PVR), postoperative PSA decline, complications, and cost are similar when compared to open and laser enucleation techniques. These outcomes position RASP as a viable MIS treatment option for patients with male LUTS needing surgical treatment for enlarged prostates. Nevertheless, prospective, randomized controlled trials (RCTs) with multicenter and large sample size are needed to confirm the findings of this systematic review.

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Surgical treatment of large volume prostates: a matched pair analysis comparing the open, endoscopic (ThuVEP) and robotic approach

Cited by 35 publications

References 22 publications

Laparoscopic simple prostatectomy vs bipolar plasma enucleation of the prostate in large benign prostatic hyperplasia: a two-center 3-year comparison

Laparoscopic simple prostatectomy vs bipolar plasma enucleation of the prostate in large benign prostatic hyperplasia: a two-center 3-year comparison

Minimally invasive simple prostatectomy in the era of laser enucleation for high-volume prostates: A systematic review and meta-analysis

Robotic-Assisted Simple Prostatectomy: A Systematic Review

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