Predictors of mid-term functional outcomes for robot-assisted Madigan simple prostatectomy: results of a multicentric series according to the BPH-6 achievement

被引:5
作者
Anceschi, Umberto [1 ,5 ]
Amparore, Daniele [2 ]
Prata, Francesco [3 ]
Tedesco, Francesco [3 ]
Cacciatore, Loris [3 ]
Checcucci, Enrico [4 ]
Bove, Alfredo M. [1 ]
DE Cillis, Sabrina [2 ]
Iannuzzi, Andrea [3 ]
Quara, Alberto [2 ]
Ragusa, Alberto [3 ]
Ortenzi, Michele [2 ]
Flammia, Rocco S. [1 ]
Zampa, Ashanti [1 ]
Misuraca, Leonardo [1 ]
Tuderti, Gabriele [1 ]
Brassetti, Aldo [1 ]
Ferriero, Mariaconsiglia [1 ]
Mastroianni, Riccardo [1 ]
Tufano, Antonio [1 ]
Fiori, Cristian [2 ]
Porpiglia, Francesco [2 ]
Gallucci, Michele [1 ]
Simone, Giuseppe [1 ]
机构
[1] IRCCS Regina Elena Natl Canc Inst, Dept Urol, Rome, Italy
[2] Univ Turin, San Luigi Hosp, Sch Med, Dept Oncol,Div Urol, Orbassano, Turin, Italy
[3] Fdn Policlin Univ Campus Biomed Rome, Dept Urol, Rome, Italy
[4] Candiolo Canc Inst FPO IRCCS, Dept Surg, Candiolo, Turin, Italy
[5] IRCCS Regina Elena Natl Canc Inst, Dept Urol, Via Elio Chianesi 53, I-00144 Rome, Italy
来源
MINERVA UROLOGY AND NEPHROLOGY | 2023年 / 75卷 / 05期
关键词
Madigan; Prostatectomy; Robotic surgical procedures; Treatment outcome;
D O I
10.23736/S2724-6051.23.05373-9
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND:BPH-6 achievement remains an objective far to be evaluated for every technique currently available for the surgical management of bladder outlet obstruction (BOO) with the goal of preserving ejaculatory function. The aim of this study was to evaluate predictors of BPH-6 achievement of urethral-sparing robot assisted simple prostatectomy (us-RASP) on a large series performed at two tertiary-care centers. METHODS:Two institutional us-RASP datasets were merged, considering eligible all patients with a follow-up >12 months. Baseline, perioperative and functional data according to BPH-6 endpoint were assessed. Descriptive analysis was used. Frequencies and proportions were reported for categorical variables while medians and interquartile ranges (IQRs) were reported for continuously coded variables. A logistic regression model was built to identify predictors of BPH-6 achievement. For all statistical analyses, a two-sided P<0.05 was considered significant. RESULTS:Study cohort consisted of 94 eligible patients. The median follow-up was 40.7 months (IQR 31.3-54.2). Overall BPH-6 achievement was 54.7%. Compared to baseline, reduction of >= 30% in IPSS was observed in 93.6% of patients, reduction of <6 points for SHIM in 95.7% and response to MSHQ-EjD question 3 indicating emission of semen in 72.6%, respectively. On multivariable analysis, prostate volume between 110-180 mL (OR 0.09; 95% CI 0.01-0.92; P=0.043) and higher preoperative SHIM score (OR 1.18; 95% CI 1.05-1.32; P<0.01) were independent predictors of BPH-6 metric achievement. CONCLUSIONS:us-RASP may provide a complete resolution of BOO and preservation of ejaculatory function in sexually active men with a prostate volume ranging 110-180 mL.
引用
收藏
页码:607 / 615
页数:9
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