Abu Dhabi, United Arab Emirates (UAE) (UroToday.com) Dr. Mohammed Shahait presented on their experience with bladder neck sparing robot-assisted simple prostatectomy. The goal of this approach was to reduce complications such as retrograde ejaculation, bladder neck contracture, and transient urinary incontinence compared with an open approach. Between 2015 to 2018, a total of 30 consecutive non-randomized patients with benign prostatic enlargement underwent bladder neck sparing robot-assisted simple prostatectomy.  The median age was 67 years, median BMI of 27.6. The median IPSS was 23 (17.5 – 27) and a median PSA of 4.5. The median prostate volume was 97g (74 – 149). 98% of patients were on alpha blockers and 43% were on 5-alpha reductase inhibitors. Their procedure is carefully described and also depicted in figure 1 below.

Figure 1 – Bladder neck sparing robot-assisted simple prostatectomy
WCE 2019 bladder neck sparing simple prostatectomy

On review, the mean operative time was 108 minutes, mean estimated blood loss of 132 ml. There was no conversion to open. No patients required continuous bladder irrigation postop. 2 complications were reported, both were UTI within 30 days. The median length of stay was 1 day. The average prostate size treated was 62.6g. 97% of patients passed their trial of void. No patients reported incontinence following catheter removal. 37% of patients developed retrograde ejaculation. At a median follow-up of 16.5 months, no patients developed bladder neck contractures.

In conclusion, they demonstrated that bladder neck sparing simple prostatectomy is reproducible, minimally invasive procedure to treat benign prostatic enlargement with a low incidence of short- and long- term complications and improved functional outcomes as compared to an open approach.

Presented by Mohammed Shahait, MD, Department of Surgery, Division of Urology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 

Written by Pengbo Jiang, MD, Department of Urology, University of California, Irvine, California at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates