Robotic-assisted simple prostatectomy after prostatic arterial embolization for large benign prostate hyperplasia: Initial experience

Sung-Chul Kam; Jung-Won Park; Myung-Ki Kim; Kun-Yung Kim; Ki-Soo Lee; Tae-Hyo Kim; Yu-Seob Shin

doi:10.1016/j.prnil.2022.04.004

Robotic-assisted simple prostatectomy after prostatic arterial embolization for large benign prostate hyperplasia: Initial experience

Prostate Int. 2022 Sep;10(3):148-151. doi: 10.1016/j.prnil.2022.04.004. Epub 2022 Apr 29.

Authors

Sung-Chul Kam¹, Jung-Won Park², Myung-Ki Kim³, Kun-Yung Kim⁴, Ki-Soo Lee⁵, Tae-Hyo Kim⁵, Yu-Seob Shin³

Affiliations

¹ Department of Urology, Gyeongsang National University Medical School, lnstitute of Health Sciences of Gyeongsang National University, Gyeongsang National University Changwon Hospital, Changwon, Korea.
² Jeonbuk National University Medical School, Jeonju, Korea.
³ Department of Urology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
⁴ Department of Radiology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.
⁵ Department of Urology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea.

Abstract

Background and objective: We aimed to evaluate the safety and efficacy of robot-assisted simple prostatectomy (RASP) after prostatic arterial embolization (PAE) in large benign prostatic hyperplasia (BPH).

Material and methods: This retrospective study included 11 cases of PAE and subsequent RASP, performed on 11 patients with BPH from March 2018 to September 2020. Clinical information on the patients was collected before surgery and 3 months after surgery. For the quantification of lower urinary tract symptoms (LUTS), International Prostate Symptom Scores (IPSSs), prostate-specific antigen (PSA) levels, urinary peak flow rate (Qmax), voided volume (Vvol), and postvoid residual volume (PVR) were measured.

Results: PAE and the subsequent RASP were successfully performed in all 11 patients. The mean total prostate volume was 129.7 ± 65.1 mL, and the transitional zone volume was 71.7 ± 5.9 mL. The mean resected prostate volume was 60.8 ± 26.1 mL. The mean hemoglobin level of the patients prior to PAE was 14.2 ± 2.3 g/dL, and one day after RASP, the hemoglobin level was 12.4 ± 1.9 g/dL. The outcome indicated that there was a considerable decline in IPSS and PVR after RASP was performed compared to before PAE (21.6 ± 9.4 vs. 10.6 ± 8.0 and 159.4 ± 145.8 mL vs. 43.9 ± 45.9 mL). Qmax and Vvol significantly improved after RASP was performed (7.6 ± 5.2 mL/s vs. 26.1 ± 12.6 mL/s; 114.2 ± 92.5 mL vs. 192.4 ± 91.8 mL, respectively).

Conclusion: This research demonstrated that RASP could be performed safely and effectively after PAE in patients with large BPH.

Keywords: Benign prostatic hyperplasia; Embolization; Prostatectomy.