Robotic enucleation

• Men experiencing moderate to severe symptoms of enlarged prostate (BPH):
  • Weak urinary flow
  • Incomplete bladder emptying
  • Stop and start urine flow
  • Straining to begin urination
  • A need to urinate often and in a hurry
  • Interrupted sleep because of the need to urinate
• This procedure is most suitable for men with a very large prostate (size greater than 150cc as measured on ultrasound or MRI)
• Men who have enlarged prostate symptoms and have failed minimally-invasive treatment options
• Men whose prostate anatomy is not appropriate for other treatment options
  Men who have failed medical therapy, don’t want to take medication or have had side effects
• Men who want to improve their quality of life to what it was before the onset of symptoms of enlarged prostate (BPH)

Robotic-assisted enucleation of prostate is a definitive surgical treatment for enlarged prostate (BPH) for the relief of bothersome urinary symptoms. The potential benefits include:

• Durable improvement in urinary symptoms with low revision rates
• Eliminates the need for lifelong use of medications
• Achieves excellent results in patients with a very large prostate who are not suitable for other procedures

The potential benefits of robotic-assisted surgery over traditional open surgery for treatment of a very large prostate include:

• Less blood loss
• Smaller incisions (keyhole)
• Shorter hospital stay
• Faster recovery time

• Robotic-assisted enucleation of prostate is performed under general anaesthesia using the da Vinci System
• The da Vinci System is a state-of-the-art robotic surgical device
• Your surgeon is 100% in control of the robotic instruments at all times
• This technology gives your surgeon:
  • High-definition 3D vision inside your body
  • Small instruments with greater range of movement than the human hand
  • Enhanced vision, more precise movements and control
• Robotic-assisted enucleation of prostate replicates the traditional open surgery but uses small robotic instruments via a keyhole approach to remove the enlarged obstructing prostate tissue, creating an open prostatic urethra (channel)

• Patients should expect to remain in hospital for 2 nights after the procedure
• A urethral catheter will be required for up to a week after the procedure to allow healing to take place
• In most cases ‘light’ activities can be resumed within a week after the procedure
• Recovery may take up to 4-6 weeks during which time strenuous activity should be avoided
• The most common side effects include discomfort or burning with urination, blood in the urine, urgent need to urinate and/or difficulty controlling the urge. Most of these symptoms generally subside within the first two weeks following the procedure

• Most patients will notice an immediate improvement in their urinary flow, pressure and bladder emptying
• Irritable bladder symptoms including urinary frequency, urgency and nocturia (getting up at night to pass urine) tend to take longer (up to 3 months) to improve

Written by Dr. Shekib Shahbaz and Dr. Tony de Sousa

Thuroff, J. W., Leicht, W., Kamal, M. M., Hampel, C., (2012), Robotic-assisted laparoscopic enucleation of benign prostatic hyperplasia (BPH)110(9), [https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.2012.11603.x], accessed 27/02/21.