MP20-16 Benign Prostatic Hyperplasia Patient Outcomes in Robotic Assisted Simple Prostatectomy vs. Prostate Enucleation: A Systematic Review and Bayesian Network Meta-analysis

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP20)1 May 2024MP20-16 Benign Prostatic Hyperplasia Patient Outcomes in Robotic Assisted Simple Prostatectomy vs. Prostate Enucleation: A Systematic Review and Bayesian Network Meta-analysis David E. Hinojosa-Gonzalez, Gal Saffati, Shane Kronstedt, Troy La, John Donato, Jackson Cathey, Justin Anderson, and Richard E. Link David E. Hinojosa-GonzalezDavid E. Hinojosa-Gonzalez , Gal SaffatiGal Saffati , Shane KronstedtShane Kronstedt , Troy LaTroy La , John DonatoJohn Donato , Jackson CatheyJackson Cathey , Justin AndersonJustin Anderson , and Richard E. LinkRichard E. Link View All Author Informationhttps://doi.org/10.1097/01.JU.0001008732.80104.31.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hyperplasia (BPH) is one of the most common medical conditions facing the aging male population. Robotic assisted simple prostatectomy (RASP) and transurethral prostate enucleation have become the leading approaches used to treat BPH. We sought to comprehensively compare outcomes in RASP and prostate enucleation used in the treatment of BPH. METHODS: In July 2023, a systematic review was performed to identify randomized controlled trials (RCTs) and retrospective studies evaluating patient outcomes in RASP versus transurethral prostate enucleation. Included studies reported the following outcomes: complication rate, flow rate, time with foley, and operative bleeding. Data was extracted independently by two authors and used to build a network to model comparisons in R. Robotic studies were grouped by single-port (SP) or multi-port (MP) approach and transvesical (TV), transperitoneal (TP), or transcapsular (TC) surgical technique; enucleation methods were holmium laser (HoLEP), thulium laser (ThuLEP), and bipolar plasma (BTUEP). Results are presented as mean difference (MD) or odds ratios (OR) with 95% credible intervals. RESULTS: We included data from 17 studies, encompassing a total of 2,978 patients, with 1,584 individuals undergoing transurethral enucleation and 1,394 receiving RASP. Our findings revealed that SP TP RASP (OR 0.20 [0.056, 0.69]) and SP TV RASP (OR 0.40 [0.22, 0.71]) exhibited a significantly lower complication rate when compared to MP TP RASP. Additionally, there was a significant reduction in operative bleeding in the SP TP RASP (MD -86.0 [-130.0, -39.0]), SP TV RASP (MD -100.0 [-130.0, -72.0]), and HoLEP (MD -160.0 [-200.0, -120.0]) groups in comparison to MP TP RASP. Moreover, all the interventions exhibited lower time with foley, with the enucleation techniques having the lowest time. Notably, no significant differences were identified in changes in flow rate between the robotic and enucleation interventions when compared to the control group. CONCLUSIONS: In conclusion, our results show that SP RASP appears to correlate with fewer complications than transurethral prostate enucleation procedures while providing similar levels of minimal operative bleeding to HoLEP. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e326 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information David E. Hinojosa-Gonzalez More articles by this author Gal Saffati More articles by this author Shane Kronstedt More articles by this author Troy La More articles by this author John Donato More articles by this author Jackson Cathey More articles by this author Justin Anderson More articles by this author Richard E. Link More articles by this author Expand All Advertisement PDF downloadLoading ...