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Purpose <p>Single-port transvesical robot-assisted simple prostatectomy (SP-SP) is a minimally invasive treatment option for patients with large prostates. However, the impact of prostate volume on perioperative outcomes, particularly in patients with extremely large glands, has not been systematically evaluated. This study aimed to assess the safety and efficacy of SP-SP across different prostate volume strata.</p> Materials and methods <p>We retrospectively reviewed 90 consecutive patients who underwent SP-SP between 2020 and 2025 by a single surgeon. Patients were stratified by preoperative total prostate volume (TPV) into Group A (80–120 mL, <i>n</i> = 43), Group B (120–160 mL, <i>n</i> = 22), and Group C (&gt;160 mL, <i>n</i> = 25). Perioperative parameters were compared among the three groups. Multivariate logistic regression analysis was performed to identify risk factors for postoperative complications.</p> Results <p>Baseline characteristics were generally comparable among groups. Pairwise comparisons showed that patients in Group C had significantly higher preoperative PSA levels than those in Group A, as well as longer operative time and greater estimated blood loss (EBL) compared with both Groups A and B. Aside from postoperative hemoglobin levels, recovery and safety outcomes were largely similar across groups. Multivariate analysis identified EBL as the only independent risk factor for postoperative complications, while TPV was not independently associated with complications. Specimen weight increased with increasing prostate volume, while the resection ratio was similar across groups. At the last follow-up, significant improvements were observed in PSA, PVR, IPSS, and QoL scores, as well as in the urinary continence across the three groups, with no significant differences between groups.</p> Conclusions <p>These findings provide preliminary evidence supporting the feasibility of SP-SP in patients with very large prostates. Larger multicenter studies with adequate sample sizes and longer follow-up are warranted to further evaluate these results.</p>

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Feasibility and safety of single-port transvesical simple prostatectomy in patients with very large prostates: A volume-stratified analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Jin-Chun Qi,
  • Sheng Tang,
  • Dong-Bin Wang,
  • Ze-Lin Fu,
  • Lorenzo Santodirocco,
  • Marwan Alkassis,
  • Ruben Sauer Calvo,
  • Chang-Bao Qu,
  • Ya-Xuan Wang,
  • Simone Crivellaro

摘要

Purpose

Single-port transvesical robot-assisted simple prostatectomy (SP-SP) is a minimally invasive treatment option for patients with large prostates. However, the impact of prostate volume on perioperative outcomes, particularly in patients with extremely large glands, has not been systematically evaluated. This study aimed to assess the safety and efficacy of SP-SP across different prostate volume strata.

Materials and methods

We retrospectively reviewed 90 consecutive patients who underwent SP-SP between 2020 and 2025 by a single surgeon. Patients were stratified by preoperative total prostate volume (TPV) into Group A (80–120 mL, n = 43), Group B (120–160 mL, n = 22), and Group C (>160 mL, n = 25). Perioperative parameters were compared among the three groups. Multivariate logistic regression analysis was performed to identify risk factors for postoperative complications.

Results

Baseline characteristics were generally comparable among groups. Pairwise comparisons showed that patients in Group C had significantly higher preoperative PSA levels than those in Group A, as well as longer operative time and greater estimated blood loss (EBL) compared with both Groups A and B. Aside from postoperative hemoglobin levels, recovery and safety outcomes were largely similar across groups. Multivariate analysis identified EBL as the only independent risk factor for postoperative complications, while TPV was not independently associated with complications. Specimen weight increased with increasing prostate volume, while the resection ratio was similar across groups. At the last follow-up, significant improvements were observed in PSA, PVR, IPSS, and QoL scores, as well as in the urinary continence across the three groups, with no significant differences between groups.

Conclusions

These findings provide preliminary evidence supporting the feasibility of SP-SP in patients with very large prostates. Larger multicenter studies with adequate sample sizes and longer follow-up are warranted to further evaluate these results.