Introduction:The da Vinci SP Ò single-port system, differently from prior platforms, utilizes a single 2.5 cm incision to accommodate 1 flexible camera and 3 articulated robotic arms. Potential advantages include shorter hospitalization, improved cosmesis, and reduced postoperative pain. This project investigates the impact of the novel single-port system on cosmetic and psychometric patient assessment. Methods:The Patient Scar Assessment Questionnaire (a validated patient-reported outcomes measure for surgical scar) has been administered retrospectively to patients who underwent either an SP or Xi Ò urological procedure at a single center. Four domains were assessed: Appearance, Consciousness, Satisfaction With Appearance, and Satisfaction With Symptoms. Higher scores represent worse reported outcomes.Results: Compared to 78 Xi procedure recipients (mean 15.28), 104 SP procedure recipients (mean 13.84) reported significantly better cosmetic scar appearance U(N SP ¼104, N MP ¼78) ¼ 3,739 (P ¼ .007) where U is the difference between the 2 rank totals, and N SP and N MP represent the number of single-port and multi-port procedure recipient respondents, respectively. Similarly, the SP cohort (mean 8.80) compared to the Xi group (mean 9.87) demonstrated significantly better consciousness of their surgical scar, U(N SP ¼104, N MP ¼78) ¼ 3,329 (P ¼ .045), and higher satisfaction with the cosmetic appearance of their surgical scar, U(N SP ¼103, N MP ¼78) ¼ 3,232 (P ¼ .022), with the SP group (mean 11.35) attaining better scores than the Xi group (mean 12.54). No significant difference was found for "Satisfaction With Symptoms," U(N SP ¼103, N MP ¼78) ¼ 3,969 (P ¼ .88), despite the SP group (mean 6.58) attaining lower scores than the Xi group (mean 6.74).Conclusions: This study demonstrates patients' favorable perception of SP versus XI surgery in terms of aesthetic outcomes. An ongoing study is investigating the relationship between cosmetic satisfaction and length of stay, postoperative pain, and narcotic use.
thulium (30 W) as regard efficacy and time needed to remove the adenoma at the level of the surgical capsule and postoperative urinary and sexual functions.METHODS: Patients with symptomatic BPH who failed medical treatment or developed BPH-related complications with prostate size larger than 80 ml and candidates for ThuLEP during the period from December 2019 to June 2021 were included. We used a 30 W Thulium laser with a 550µm laser fiber and a 26 Fr continuous flow resectoscope. Data collected included prostate size, PSA, enucleation and morcellation time, postoperative IPPS, & IEFF-5 scores at one week, 1, 3 & 6 months.RESULTS: Thirty-seven patients underwent ThuLEP with a mean age of 68AE6. Refractory retention was the main indication for surgery in 21.6% of patients, hematuria in 8% & failed medical treatment in 70%.3 with a mean IPPS score of 25.6AE2.2. The mean prostate size was 111AE20 ml and the mean Qmax was 6.8AE2 ml/sec. The mean enucleation time was 70AE10 min, and the mean morcellation time was 24AE6 min. The mean reduction in PSA level after 6 months was 3.4AE1.1 & the mean hemoglobin drop was 1.7AE0.6 mg/dl. The 1st follow-up visit was at one week with a mean IPSS 8.3AE1.9, mean Qmax improvement of 26AE4.6 ml/s. Our results showed significant improvement in postoperative urgency and UUI (p-value[0.005) with no significant change in IIEF-5 score at 6-month follow-up compared to baseline.CONCLUSIONS: Lowepower ThuLEP is an efficient technique for prostate enucleation with less escharing effects and satisfactory urinary and sexual outcomes.
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