Despite significant developments in transurethral surgery for benign prostatic hyperplasia (BPH), simple prostatectomy remains an excellent option for patients with large glands.To describe our technique of robotic enucleation of prostate (REP).

From October 2016 to October 2019, 4 patients underwent REP. We performed REP using our technique. Baseline demographics, pathology data, perioperative complications, and functional outcomes were assessed.

Mean patient age was 72.8 yr (range: 62-89), baseline International Prostate Symptom Score (IPSS) was 23 (range: 18-30), prostate volume was 193.8 ml (range: 56-270), postvoid residual (PVR) was 650 ml (range: 96-1500), and preoperative prostate-specific antigen was 11.6 ng/ml (range: 4.1-20.8). One patient was catheter dependent before surgery. Estimated blood loss was 231 ml (range: 75-550), and the hospital stay was 4.6 days (range: 4-7). The length of catheterisation was 7 days. There were no intraoperative complications and no conversions to open surgery. Two patients had a concomitant robotic procedure performed (one hernia repair and one diverticulectomy). Early functional outcomes demonstrated improvement from baseline with a 95% reduction in mean PVR. One patient had a wound infection on the drain site. The final pathologies were all benign.

This study is limited by small sample size and short follow-up period. Our technique of REP is safe and effective. Good functional outcomes suggest it is a viable option for BPH and larger glands and can be used for patients requiring concomitant procedures. The procedure is both feasible and safe and a good option for benign prostatic hyperplasia with larger glands.