Abstract：
OBJECTIVE: To compare the perioperative and postoperative outcomes between traditional trans-vesical robot-assisted simple prostatectomy (TV-RASP) and the newly introduced urethral-sparing (US) RASP.
METHODS: We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation.
RESULTS: This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001).
CONCLUSIONS: US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP.
METHODS: We retrospectively reviewed 42 patients who underwent TV-RASP (n=22) or US-RASP (n=20) performed by two experienced surgeons at two tertiary centers. Perioperative outcomes including operation time, estimated blood loss, length of hospital stay, and catheterization time were assessed. Postoperative outcomes were evaluated using the International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry parameters, Male Sexual Health Questionnaire-Ejaculation Dysfunction-Short Form (MSHQ-EjD-SF) scores, and maintenance of anterograde ejaculation.
RESULTS: This study analyzed 22 and 20 patients who underwent TV-RASP and US-RASP, respectively. Except for the TV-RASP group being older (70.0 years) than the US-RASP group (64.5 years) (p=0.028), no differences among other baseline characteristics existed. Perioperative outcomes indicated that hospital stay and catheterization time were significantly shorter in the US-RASP group than in the TV-RASP group (p<0.001). At postoperative month 1, the median IPSS and QoL scores were significantly better in the US-RASP group than in the TV-RASP group (p=0.001 and p=0.002, respectively). However, at months 6 and 12, no significant differences were noted in IPSS, QoL, maximum flow rate, and postvoid residual urine between the two groups. Sexually active patients in the US-RASP group maintained postoperative MSHQ-EjD functional and bother scores, whereas the TV-RASP group experienced a decline. Notably, 75.0% of patients in the US-RASP group preserved antegrade ejaculation, compared to only 20.0% in the TV-RASP group (p<0.001).
CONCLUSIONS: US-RASP is not inferior to TV-RASP in terms of functional outcomes. In addition, US-RASP yielded more rapid symptom improvements and preserved antegrade ejaculation than TV-RASP. However, larger prospective studies are required to confirm these findings and to further investigate the long-term efficacy and safety of US-RASP.
摘要：
目的：比较传统的经膀胱机器人辅助单纯前列腺切除术（TV-RASP）和新引入的保留尿道（US）RASP的围手术期和术后结局。
方法：我们回顾性分析了42例接受TV-RASP（n=22）或US-RASP（n=20）的患者，这些患者由两个三级中心的两名经验丰富的外科医生进行。围手术期结果包括手术时间，估计失血量,住院时间,并评估导管插入时间。使用国际前列腺症状评分（IPSS）评估术后结果，生活质量（QoL），尿流图参数,男性性健康问卷-射精功能障碍-简表(MSHQ-EjD-SF)评分,和维持顺行射精。
结果：本研究分析了22和20例接受TV-RASP和US-RASP的患者，分别。除了TV-RASP组年龄（70.0岁）比US-RASP组（64.5岁）大（p=0.028），其他基线特征之间无差异.围手术期结果表明，US-RASP组的住院时间和导管插入时间明显短于TV-RASP组（p<0.001）。术后1个月，US-RASP组的IPSS和QoL评分中位数明显优于TV-RASP组（分别为p=0.001和p=0.002）。然而,在第6个月和第12个月，IPSS没有发现显著差异，QoL,最大流量,两组之间的残余尿液。US-RASP组的性活动患者术后保持了MSHQ-EjD功能和打扰评分，而TV-RASP组经历了下降。值得注意的是,US-RASP组75.0%的患者保留顺行射精,而TV-RASP组仅为20.0%(p<0.001)。
结论：US-RASP在功能结局方面并不逊色于TV-RASP。此外,与TV-RASP相比，US-RASP产生了更快的症状改善和保留的顺行射精。然而,需要更大的前瞻性研究来证实这些发现,并进一步研究US-RASP的长期疗效和安全性.
方法：我们回顾性分析了42例接受TV-RASP（n=22）或US-RASP（n=20）的患者，这些患者由两个三级中心的两名经验丰富的外科医生进行。围手术期结果包括手术时间，估计失血量,住院时间,并评估导管插入时间。使用国际前列腺症状评分（IPSS）评估术后结果，生活质量（QoL），尿流图参数,男性性健康问卷-射精功能障碍-简表(MSHQ-EjD-SF)评分,和维持顺行射精。
结果：本研究分析了22和20例接受TV-RASP和US-RASP的患者，分别。除了TV-RASP组年龄（70.0岁）比US-RASP组（64.5岁）大（p=0.028），其他基线特征之间无差异.围手术期结果表明，US-RASP组的住院时间和导管插入时间明显短于TV-RASP组（p<0.001）。术后1个月，US-RASP组的IPSS和QoL评分中位数明显优于TV-RASP组（分别为p=0.001和p=0.002）。然而,在第6个月和第12个月，IPSS没有发现显著差异，QoL,最大流量,两组之间的残余尿液。US-RASP组的性活动患者术后保持了MSHQ-EjD功能和打扰评分，而TV-RASP组经历了下降。值得注意的是,US-RASP组75.0%的患者保留顺行射精,而TV-RASP组仅为20.0%(p<0.001)。
结论：US-RASP在功能结局方面并不逊色于TV-RASP。此外,与TV-RASP相比，US-RASP产生了更快的症状改善和保留的顺行射精。然而,需要更大的前瞻性研究来证实这些发现,并进一步研究US-RASP的长期疗效和安全性.
