MP20-18 Laser Enucleation of the Prostate versus Robot Assisted Simple Prostatectomy: Head-to-Head Comparison

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP20)1 May 2024MP20-18 Laser Enucleation of the Prostate versus Robot Assisted Simple Prostatectomy: Head-to-Head Comparison Ella Taubenfeld, Robert Chang, Jared Faith, Aleem Khan, Bertie Zhang, Sarah Razavi, Alexa Meyer, and Lee Richstone Ella TaubenfeldElla Taubenfeld , Robert ChangRobert Chang , Jared FaithJared Faith , Aleem KhanAleem Khan , Bertie ZhangBertie Zhang , Sarah RazaviSarah Razavi , Alexa MeyerAlexa Meyer , and Lee RichstoneLee Richstone View All Author Informationhttps://doi.org/10.1097/01.JU.0001008732.80104.31.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic assisted simple prostatectomy (RASP) and laser enucleation of the prostate (LEP) are the two mainstays of minimally invasive therapies for the surgical management of enlarged prostate (>80 ml). In this study, we aim to compare perioperative and postoperative outcomes in patients treated with LEP versus RASP. METHODS: We performed a retrospective review of patients treated with LEP or RASP within a single health system from 2014-2021. Demographic data, perioperative outcomes, and postoperative outcomes were collected. Data was analyzed using descriptive statistics and comparative analyses were performed in R software. RESULTS: A total of 448 patients were identified; 347 patients underwent LEP and 101 underwent RASP, with a median follow-up of 108.9 weeks in the LEP group and 82.3 weeks in the RASP group (p=0.53). Groups were comparable in terms of demographic data. Patients who underwent RASP had significantly larger prostates than patients who underwent LEP (mean 137cc vs. 100cc, p<0.0001). In terms of operative outcomes, the LEP group had significantly shorter operative time (mean 129 min vs. 198 min, p<0.0001), lower estimated blood loss (median 100mL vs. 200mL, p<0.0001), and less tissue volume removed (mean 53.0g vs. 77.7g, p=0.0001) (Table 1). Postoperatively, there were no significant differences in Clavien complications (Table 1). Patients who underwent RASP were more likely to have longer length of post-operative catheters (median 9 days vs. 1 day in the LEP group, p<0.0001) and have post-operative de novo erectile dysfunction (ED) compared to the LEP group (11.2% vs. 4.2%, p=0.013). Patients in the LEP group were more likely to experience post-operative stress urinary incontinence (SUI) (40.1% vs. 13.1%, p<0.0001). CONCLUSIONS: Comparisons of outcomes in LEP versus RASP remain underpowered in the literature. This study shows that both LEP and RASP are safe and efficacious procedures with clinically comparable post-operative PVR nadirs. Patients who underwent LEP had decreased operative time and blood loss, though with smaller baseline prostates and less volume resected. While both procedures are safe, the complication profiles differ in terms of ED and SUI. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e327 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ella Taubenfeld More articles by this author Robert Chang More articles by this author Jared Faith More articles by this author Aleem Khan More articles by this author Bertie Zhang More articles by this author Sarah Razavi More articles by this author Alexa Meyer More articles by this author Lee Richstone More articles by this author Expand All Advertisement PDF downloadLoading ...