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Moderated Poster Abstract
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Abstract
Suprapubic Transvesical Adenoma Resection of the Prostate (STAR-P) to treat glands ≧ 80 ml: early surgical outcomes compared with Robot-assisted simple prostatectomy (RASP)
Moderated Poster Abstract
Clinical Research
Functional Urology: Incontinence and Voiding Dysfunction
Author's Information
10
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Italy
Bruno Bucca bruno.bucca@uniroma1.it Sapienza University of Rome Urology Rome Italy *
Aldo Brassetti aldo.brassetti@ifo.it IRCCS Regina Elena National Cancer Institute Urology Rome Italy -
Alfredi Maria Bove alfredo.bove@ifo.it IRCCS Regina Elena National Cancer Institute Urology Rome Italy -
Costantino Leonardo costantino.leonardo@gmail.com IRCCS Regina Elena National Cancer Institute Urology Rome Italy -
Rocco Simone Flammia roccosimone92@gmail.com IRCCS Regina Elena National Cancer Institute Urology Rome Italy -
Flavia Proietti flavia.proietti@uniroma1.it IRCCS Regina Elena National Cancer Institute Urology Rome Italy -
Leslie Claire Licari leslieclaire.licari@uniroma1.it Sapienza University of Rome Urology Rome Italy -
Eugenio Bologna eugenio.bologna@uniroma1.it Sapienza university of Rome Urology Rome Italy -
Giuseppe Simone giuseppe.simone@ifo.it IRCCS Regina Elena National Cancer Institute Urology Rome Italy -
Christian Gozzi christian.gozzi@gmail.com City Clinic Urology Bolzano Italy -
 
 
 
 
 
 
 
 
 
 
Abstract Content
STAR-P is a minimally invasive procedure for the treatment of benign prostatic obstruction (BPO). Utilizing a trans-vesical resectoscope with a bipolar loop (Gozzi System 42Ch by Tontarra), this approach allows for the resection of adenomas exceeding 80 grams via a mini-laparotomic suprapubic access, with the aim of preserving the urethra and the external sphincter.
A dataset was created by combining prospectively collected data on STAR-P and RASP procedures, from the 2 participating institutions. Only patients with a prostate volume (PV) ≥ 80 ml were included. Demographics, perioperative factors, and early outcomes up to 1 month were compared between the two cohorts. Differences between the groups were assessed using chi-square tests for categorical variables and Wilcoxon tests for continuous ones. Surgical quality was evaluated using the Trifecta (post-operative maximum flow rate [Qmax] >15 ml/sec, IPSS score < 8 and absence of complications) composite outcome.
Overall, 26 patients underwent STAR-P and 35 had RASP. Patients in the former cohort were older (69 years vs 64 years; p=0.02) and more symptomatic (preoperative IPSS: 25 vs 29; p=0.005), but prostate volume and Qmax at baseline were comparable in the two groups (all p>0.35) (Table1). At 1 month follow-up, no significant difference in terms of Trifecta rate was observed between the two cohorts (42% vs 54%; p=0.35) (Figure 1), although the rate of patients with Qmax >15 ml/sec was significantly higher after robotic surgery (87% vs 42 %; p<0.001), while the percentage of patients with postoperative IPSS < 8 was significantly higher in the STAR-P group (100% vs 67%; p=0.001). No major perioperative complications occurred in either group. No cases of stress urinary incontinence or bladder-neck contracture were reported.
STAR-P appears to be an effective and safe treatment for patients with large prostates. Though the obstruction relief may not match robotic enucleation, the overall surgical outcomes are similar. Further data with larger patient populations and long-term follow-up are needed to confirm these findings.
BPH;BOO
 
 
 
 
 
 
 
 
 
 
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