Mp62-04 Comparative Analysis of Perioperative and Functional Outcomes After Aquablation Androbot-Assisted Simple Prostatectomy for the Treatment of BPH

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-04 COMPARATIVE ANALYSIS OF PERIOPERATIVE AND FUNCTIONAL OUTCOMES AFTER AQUABLATION ANDROBOT-ASSISTED SIMPLE PROSTATECTOMY FOR THE TREATMENT OF BPH Daniele Amparore, Alberto Quarà, Stefano De Luca, Sabrina De Cillis, Enrico Checcucci, Federico Piramide, Michele Sica, Michele Ortenzi, Luca Ferrando, Matteo Manfredi, Cristian Fiori, and Francesco Porpiglia Daniele AmparoreDaniele Amparore , Alberto QuaràAlberto Quarà , Stefano De LucaStefano De Luca , Sabrina De CillisSabrina De Cillis , Enrico CheccucciEnrico Checcucci , Federico PiramideFederico Piramide , Michele SicaMichele Sica , Michele OrtenziMichele Ortenzi , Luca FerrandoLuca Ferrando , Matteo ManfrediMatteo Manfredi , Cristian FioriCristian Fiori , and Francesco PorpigliaFrancesco Porpiglia View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Surgical treatment of symptomatic benign prostatic hyperplasia (BPH) has evolved over the last few decades with increased focus on minimally-invasiveness and preservation of sexual and ejaculatory function. The aim of this study was to compare perioperative and functional outcomes of two robot-assisted surgical techniques for the treatment of BPH: robot-assisted simple prostatectomy with urethral preservation (usRASP) and Aquablation (AB). METHODS: We retrospectively extracted from our prospectively maintained databases all patients with at least 12-month follow-up who underwent AB or usRASP at our Institution between 02/2017 and 02/2022. PSM was applied based on the International Prostate Symptom Score (IPSS) questionnaire, prostate volume and max-flow rate. All interventions were performed by a single surgeon per type of procedure. Demographics, perioperative data and complications (according to Clavien–Dindo system) were assessed. Functional outcomes were recorded at 1 months with evaluation of maximum flow rate (Qmax) at uroflowmetry and at 3, 6 and 12 months with evaluation of Qmax, post void residue (PVR), International Prostate Symptom Score (IPSS), QoL-IPSS, Male Sexual Health Questionnaire for ejaculatory dysfunction (MSHQ-EjD). For the porpoise of this study, an ad-hoc trifecta definition was used to assess "success" of the surgical procedures defined as the contemporary presence of: a) no postoperative complications > Clavien-Dindo 2 within the first postoperative month; b) 1-month postoperative Qmax >15ml/s and c) antegrade ejaculation at 3-month evaluation. RESULTS: Overall, 65 usRASP and 75 AB were extracted. No differences were found in perioperative data between the two groups, except for mean (SD) operative time that was found to be shorter in the AB group (64.6 (14.4) vs 111.9 (23.6) min; p<0.05). No intraoperative complication occurred in both groups. Early postoperative complication rate was lower, even if not statistically significant, in the AB cohort (10.7% vs 15.4%; p 0.366); 1 (1.5%) and 2 (2.7%) complications Clavien-Dindo >2 were recorded in the usRASP and AB cohort, respectively. Postoperative antegrade ejaculation was preserved in 96.0% of patients underwent AB, whilst in 76.9% of usRASP group (p<0.05). 1-month Qmax was found comparable between the groups (mean 23.4 (1.2) ml/s in usRASP vs 20.4 (2.2) ml/sec in AB; p>0.05). 3 months median Qmax was 19.2 (2.4) and 22.5 (2.1) ml, and median (IQR) IPSS score was 4 (2-5) and 5 (1-5) points for AB and RASP group respectively (p>0.05); median (IQR) IPSS-QoL score (1 (0-1) vs 2 (0-2); p<0.05) and mean (SD) PVR (19.1 (10.1) vs 26.4 (11.2) ml; p 0.07) results were found to be better in usRASP group. Overall, Trifecta rate was significantly higher in AB cohort (94.3% vs 75.4%; p<0.05). CONCLUSIONS: AB and RASP are safe and effective treatments for symptomatic BPH. RASP has shown slightly better urinary functional outcomes than AB in terms of IPSS-QoL and PVR. Whilst, AB seems to be more effective in antegrade ejaculation preservation, even in comparison to usRASP. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1021 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Daniele Amparore More articles by this author Alberto Quarà More articles by this author Stefano De Luca More articles by this author Sabrina De Cillis More articles by this author Enrico Checcucci More articles by this author Federico Piramide More articles by this author Michele Sica More articles by this author Michele Ortenzi More articles by this author Luca Ferrando More articles by this author Matteo Manfredi More articles by this author Cristian Fiori More articles by this author Francesco Porpiglia More articles by this author Expand All Advertisement PDF downloadLoading ...