Robot-Assisted Simple Prostatectomy vs Endoscopic Enucleation of the Prostate: A Systematic Review and Meta-Analysis of Comparative Trials

The Multi-Institutional Experience in Single-Port Robotic Transvesical Simple Prostatectomy for Benign Prostatic Hyperplasia Management. Letter.

“…In a recent systematic review and meta-analysis, Kowalewski et al indicated both EEP and RASP offer excellent improvement of symptoms due to prostatic hyperplasia, but EEP should be the first choice for lower blood loss, shorter catheterization time and length of hospital stay. 5 In the current study, however, the median (IQR) estimated blood loss was 100 cc (50, 200), the median (IQR) postoperative hospital stay was 21.0 hours (6.5, 26.0) and only 3 patients (3%) developed Clavien Grade 2 postoperative complications. Although the median (IQR) Foley catheter duration was 5 days (5, 7), most of the safety parameters have made enormous improvements 6,7 and are comparable with holmium laser enucleation of the prostate.…”

“…Although the median (IQR) Foley catheter duration was 5 days (5, 7), most of the safety parameters have made enormous improvements 6,7 and are comparable with holmium laser enucleation of the prostate. 5 The single-port transvesical approach and the small size of the cystotomy allows for minimal disturbance of surrounding structures. We congratulate the authors for their epoch-making study.…”

Contrast-Enhanced Ultrasound and Shear Wave Elastography: Novel Methods for the Evaluation of Urethral Stricture Disease. Letter.

“…In comparison, SWE in liver disease requires a mean or median value across 5e10 ROI measurements, in addition to interquartile-range-to-median ratio <30% as benchmark quality checks to ensure accuracy. 4,5 How many ROI measurements are needed in urethral stricture disease? Where should these ROIs be measured along the length of the stricture and how do we account for potential heterogeneity of spongiofibrosis along the total length of the stricture?…”

“…Although the median (IQR) Foley catheter duration was 5 days (5, 7), most of the safety parameters have made enormous improvements 6,7 and are comparable with holmium laser enucleation of the prostate. 5 The single-port transvesical approach and the small size of the cystotomy allows for minimal disturbance of surrounding structures. We congratulate the authors for their epoch-making study.…”

Editorial Comment

“…As the techniques got more sophisticated and the procedure has attracted more attention, the optimal surgical management of large benign prostatic hyperplasia (BPH), comparison of RASP and endoscopic enucleation of the prostate (EEP), is now an issue of ongoing debate. While EEP has been associated with lower blood loss, shorter catheterization time and shorter hospital stay compared with RASP, 1 advantages of RASP are thought to include the lower possibility of urethral trauma and postoperative storage symptoms, and a shorter learning curve. 2…”