Modeling the Perioperative Outcomes of Transvesical Single Port Robot-Assisted Radical Prostatectomy in a Cohort Who Underwent Other Approaches of Single Port Radical Prostatectomy: A Report From the Single Port Advanced Research Consortium (SPARC)

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: In recent years, various approaches of Single Port (SP) Robot-Assisted Radical Prostatectomy (RARP) have been introduced. This study sought to evaluate the clinical outcomes of all SP-RARP patients eligible for the TV approach, with a specific focus on comparing the clinical outcomes of TV SP-RARP with other SP approaches. METHODS: We conducted a retrospective review of the prospectively maintained, IRB-approved database of the Single Port Advanced Research Consortium (SPARC) to identify 2,266 consecutive patients who underwent SP-RARP between 2018 and 2024. All cases were performed using the SP robotic platform either via Extraperitoneal (EP), Transperitoneal (TP), or TV techniques. Propensity-matching was employed based on prostate volume, preoperative PSA, and biopsy Gleason Grade Group to identify all patients in the non-TV group that met the inclusion criteria for the TV approach. Perioperative and postoperative outcomes were analyzed with descriptive statistics, and Numbers Needed to Treat (NNT) was calculated as the inverse of the absolute risk ratio. RESULTS: Following a 1:1 propensity-matched analysis, 322 patients were included in each of the SP TV and non-TV groups, with the non-TV cohort comprising 211 (65.5%) EP and 111 (34.5%) TP cases. All TV procedures were competed successfully without conversion or additional ports. The TV approach was associated with significantly reduced blood loss (median, TV 70 vs. non-TV 100 mL, p< 0.001), with no increase in operative time (p=0.122) or positive surgical margin rates (p=0.141). Notably, TV SP-RARP demonstrated significant benefits in enhancing postoperative recovery, especially in facilitating outpatient procedures (NNT 3.2; TV 89.3% vs. non-TV 58.4%, p< 0.001) and reducing opioid prescriptions at discharge (NNT 2.8; TV 8.1% vs. non-TV 43.9%, p< 0.001). Furthermore, early urinary continence was improved in the TV group, with 43% achieving immediate continence, and a significantly improved 6-week continence rate (NNT 3.2; TV 67% vs. non-TV 36.2%, p< 0.001). The incidence of major postoperative complications remained similarly low following the different approaches (TV 1.2% vs. non-TV 1.9%, =[0.524). CONCLUSIONS: In this multi-institutional cohort study, the Transvesical SP-RARP approach conferred significant benefits towards enhancing postoperative recovery and early urinary continence outcomes.

Volume

213

Issue

5S

First Page

e1205

Last Page

e1206

Comments

American Urological Association Annual Meeting, April 26-29, 2025, Las Vegas, NV

DOI

10.1097/01.JU.0001110140.31907.5b.38

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