Mp37-16 Single-Port Robotic Transvesical Partial Prostatectomy: A New Form of Focal Treatment in Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I (MP37)1 May 2024MP37-16 SINGLE-PORT ROBOTIC TRANSVESICAL PARTIAL PROSTATECTOMY: A NEW FORM OF FOCAL TREATMENT IN PROSTATE CANCER Adriana Marcela Pedraza Bermeo, Ethan L. Ferguson, Roxana Ramos-Carpinteyro, Nicolas Soputro, Jaya Chavali, Carter Mikesell, and Jihad Kaouk Adriana Marcela Pedraza BermeoAdriana Marcela Pedraza Bermeo , Ethan L. FergusonEthan L. Ferguson , Roxana Ramos-CarpinteyroRoxana Ramos-Carpinteyro , Nicolas SoputroNicolas Soputro , Jaya ChavaliJaya Chavali , Carter MikesellCarter Mikesell , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001008948.02935.01.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Given the favorable cancer-specific survival rates in localized prostate cancer and the negative impact of whole-gland treatments on functional outcomes, the field is moving towards precision strategies such as focal therapy and organ-sparing surgery. We aim to report medium-term functional and oncologic outcomes for the initial Single-Port Robotic Transvesical Partial Prostatectomy (SP-TVRAPP) patient cohort. METHODS: We retrospectively analyzed a prospectively maintained database of 17 patients who underwent SP-TVRAPP between February 2021 and February 2023. Inclusion criteria were PSA ≤10 ng/mL, clinical stage ≤cT2b, ISUP Grade Group ≤3, unilateral lesion on mpMRI with positive biopsy cores on the same side, and preoperative IIEF-5 ≥17. We also considered bilateral cancer in the anterior zone and invisible mpMRI tumors confirmed by unilateral positive biopsies. RESULTS: At baseline, patients had an average age of 61 years, a median PSA of 4.8 ng/mL (IQR 3.7-7.7), and a median SHIM score of 23 (IQR 18-25). Procedures were complication-free, with no need for extra ports or conversion. After a median hospital stay of 3.9 hours, 94% were discharged without opioid prescriptions, and Foley catheters were removed after about 4 days. Potency (SHIM ≥17) was achieved by 35.3%, 68.7%, and 81.2% at 6 weeks, 3 months, and 6 months, respectively, with 37.5% not needing phosphodiesterase type 5 inhibitors. Regarding urinary function, 82.3% were continent at 6 weeks, increasing to 93.7% at 3 and 6 months. Oncologically, 29% were upgraded, 35% upstaged, and 82% had negative surgical margins. Median PSA was 0.4 ng/ml (IQR 0.2-1.2) twelve months after SP-TVRAPP. Two men had residual GG1 cancer in follow-up biopsies and are on active surveillance. At a mean follow-up of 15.2 (range 6.2-29.5) months, none of the patients have required secondary interventions, and all remain free of both clinically significant residual prostate cancer and metastatic disease. CONCLUSIONS: SP-TVRAPP is a promising approach for selected patients with localized prostate cancer. This focal surgical technique resulted in an expedited postoperative recovery and yielded high rates of erectile function and urinary continence while maintaining oncologic safety. Further studies are needed to verify these findings and assess long-term outcomes. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e609 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Adriana Marcela Pedraza Bermeo More articles by this author Ethan L. Ferguson More articles by this author Roxana Ramos-Carpinteyro More articles by this author Nicolas Soputro More articles by this author Jaya Chavali More articles by this author Carter Mikesell More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...