Robot-Assisted Laparoscopic Simple Prostatectomy in Men with Bladder Outlet Obstruction: Modified Urinary Reconstruction Leading to Improving Perioperative Outcomes

Purpose: Robot-assisted laparoscopic simple prostatectomy (RALSP) is a feasible option in men with markedly enlarged prostates (over 100 g) and urinary obstruction.1 Since January 2011, we have modified our surgical method in hope of further enhancing the perioperative outcomes related to RALSP. Herein, we report our initial experience utilizing a circumferential urinary reconstruction technique. Methods: A total of nine patients underwent RALSP with a surgical modification for symptomatic benign prostatic hypertrophy (BPH) in 2011. All, but one patient, were in complete urinary retention preoperatively. All RALSP were performed via the suprapubic approach. Upon removal of the obstructing prostate adenomas, a circumferential anastomosis was completed by advancing and approximating the bladder neck to the prostate urethral stump with 8 to 10 interrupted 2-0 vicryl suture, similar to that of the urethral vesical anastomosis during robotic radical prostatectomy. Six patients who underwent a standard...