MP62-10 ENDOSCOPIC ENUCLEATION OF THE PROSTATE WITH THULIUM:YAG LASER (ThuLEP) VERSUS ROBOT-ASSISTED SIMPLE PROSTATECTOMY (RASP) FOR PROSTATES >150 ML: PERIOPERATIVE AND FUNCTIONAL OUTCOMES

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-10 ENDOSCOPIC ENUCLEATION OF THE PROSTATE WITH THULIUM:YAG LASER (ThuLEP) VERSUS ROBOT-ASSISTED SIMPLE PROSTATECTOMY (RASP) FOR PROSTATES >150 ML: PERIOPERATIVE AND FUNCTIONAL OUTCOMES Davide Perri, Umberto Besana, Andrea Pacchetti, Elena Morini, Federica Mazzoleni, Enrica Verzotti, Antonio Luigi Pastore, Tiago Ribeiro de Oliveira, Rocco, and Giorgio Bozzini Davide PerriDavide Perri , Umberto BesanaUmberto Besana , Andrea PacchettiAndrea Pacchetti , Elena MoriniElena Morini , Federica MazzoleniFederica Mazzoleni , Enrica VerzottiEnrica Verzotti , Antonio Luigi PastoreAntonio Luigi Pastore , Tiago Ribeiro de OliveiraTiago Ribeiro de Oliveira , Rocco Rocco , and Giorgio BozziniGiorgio Bozzini View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To compare preoperative and functional outcomes between endoscopic enucleation of the prostate with Thulium:YAG laser (ThuLEP) and Robot-Assisted Simple Prostatectomy (RASP) for the surgical management of prostates >150 ml. METHODS: Patients with lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) with prostate volume >150 ml were treated. In Group A patients underwent ThuLEP with the Cyber TM generator (Quanta System). In Group B patients underwent transvesical RASP using the Da Vinci Xi robot. Perioperative outcomes were assessed. Micturition improvements were evaluated through the International Prostate Symptoms Score (IPSS), maximum flow rate (Qmax) and post-void residual (PVR) preoperatively and 6 months after surgery. RESULTS: 102 patients were treated. Preoperative features were comparable between groups. 50 patients (49.0%) underwent ThuLEP (Group A), while 52 patients (51.0%) underwent transvesical RASP (Group B). Mean prostate volume was 172.9 ml in Group A vs. 169.4 ml in Group B (p=0.09). Mean total operative time was 95.3 min for ThuLEP and 89.7 min for RASP (p=0.07). Mean enucleation time was 67.8 min for ThuLEP and 41.8 min for RASP (p=0.04). Mean catheterization time was 1.9 vs. 8.9 days (p=0.02), mean length of stay was 2.3 vs. 2.4 days (p=0.18), mean haemoglobin drop at first postoperative day was 1.1 vs. 1.8 g/dl (p=0.09) for Group A vs. Group B, respectively. Overall complication rate was comparable (8.2% vs. 9.6%, p=0.13). Transfusions were required in 1 patient (2.0%) after ThuLEP and 1 patient (1.9%) after RASP (p=0.17). 6 months after surgery no differences were observed according to mean IPSS score (4.2 vs. 3.8, p=0.23), mean Qmax (22.3 vs. 24.7 ml/s, p=0.15) and mean PVR (21.2 vs. 34.8 ml, p=0.13). CONCLUSIONS: ThuLEP and RASP proved to be effective and reliable alternatives for BPH treatment in case of large prostates (>150 ml) with no significant differences according to micturition improvements. Mean enucleation time was shorter with RASP, whereas mean total operative time was comparable between the two treatments. The known higher costs of robotic surgery should be taken into account. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1024 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Davide Perri More articles by this author Umberto Besana More articles by this author Andrea Pacchetti More articles by this author Elena Morini More articles by this author Federica Mazzoleni More articles by this author Enrica Verzotti More articles by this author Antonio Luigi Pastore More articles by this author Tiago Ribeiro de Oliveira More articles by this author Rocco More articles by this author Giorgio Bozzini More articles by this author Expand All Advertisement PDF downloadLoading ...

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