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Prostatectomy

A prostatectomy is a surgical procedure involving the removal of part or all of the prostate gland, a walnut-sized organ in the male reproductive system located below the bladder and surrounding the urethra, which produces fluid that nourishes and transports sperm.^[1]^[2] This surgery is most commonly performed to treat prostate cancer, where it aims to remove cancerous tissue while potentially preserving surrounding structures, or to alleviate urinary symptoms caused by benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate.^[1]^[3] There are two primary types of prostatectomy: radical prostatectomy, which removes the entire prostate gland along with some surrounding tissue, including the seminal vesicles, and is the standard surgical approach for localized prostate cancer in otherwise healthy patients; and simple prostatectomy, which targets only the inner portion of the prostate to relieve BPH-related obstruction without addressing cancer.^[1]^[3] Radical procedures are recommended for cancers confined to the prostate (stages I and II), offering a potentially curative option compared to alternatives like radiation therapy or active surveillance, though they carry risks of side effects such as urinary incontinence and erectile dysfunction.^[3]^[4] Modern prostatectomies are conducted via several approaches to minimize invasiveness and improve outcomes: open surgery involves a single incision in the lower abdomen (retropubic) or between the anus and scrotum (perineal) for direct access; laparoscopic prostatectomy uses several small abdominal incisions and a camera-guided tool; and robot-assisted laparoscopic prostatectomy (RALP) employs robotic arms controlled by the surgeon for enhanced precision, shorter hospital stays, reduced blood loss, and faster recovery, though it does not necessarily improve long-term cancer control rates over open methods.^[1]^[3]^[5] Nerve-sparing techniques during radical prostatectomy can help preserve erectile function in up to 60-80% of suitable cases, depending on cancer stage and patient factors, but postoperative incontinence affects about 5-20% of patients long-term.^[4]^[5] Preparation for prostatectomy typically includes imaging, biopsies, and discussions of risks, with patients advised to stop blood thinners and undergo bowel preparation; recovery involves catheterization for 1-2 weeks, gradual return to activities, and follow-up PSA testing to monitor for recurrence, which occurs in approximately 20-30% of radical cases within 10 years.^[1]^[3] Recent advances, such as single-port robotic systems and improved imaging for better tumor localization, continue to refine these procedures, emphasizing multidisciplinary care to balance oncologic efficacy with quality-of-life preservation.^[5]

Overview

Definition and Purpose

A prostatectomy is a surgical procedure involving the removal of part or all of the prostate gland, which is a walnut-sized organ in the male reproductive system located below the bladder and surrounding the urethra. The prostate produces seminal fluid that nourishes and transports sperm during ejaculation, contributing to both reproductive and urinary functions by encircling the urethra, through which urine passes from the bladder.^[6]^[1] The primary purposes of prostatectomy are to alleviate urinary obstruction caused by benign prostatic hyperplasia (BPH), where the gland enlarges and compresses the urethra, or to treat localized prostate cancer by excising the affected tissue. In cases of BPH, a simple prostatectomy removes the inner portion of the prostate to relieve symptoms such as frequent urination or incomplete bladder emptying, without addressing malignancy.^[1] For prostate cancer, a radical prostatectomy aims for curative intent by removing the entire prostate gland along with nearby structures, such as the seminal vesicles, to eliminate cancerous cells in early-stage disease. This distinction between simple (palliative for benign conditions) and radical (curative for malignant ones) approaches guides the procedure's scope based on the underlying pathology.^[1]^[7]

Types of Prostatectomy

Prostatectomy procedures are classified primarily by the extent of prostate tissue removal and the scope of the operation, distinguishing between those addressing benign conditions like benign prostatic hyperplasia (BPH) and those targeting malignant diseases such as prostate cancer.^[8] Simple prostatectomy involves partial removal, while radical prostatectomy entails complete excision; emerging partial or focal approaches aim to limit resection to affected areas in select cases.^[9]^[10] Simple prostatectomy is a surgical intervention for benign prostate enlargement, specifically targeting the inner transitional zone or adenoma while preserving the outer prostatic capsule and surrounding structures to maintain continence and sexual function.^[9] This procedure is indicated for large prostates greater than 80-100 grams unresponsive to medical therapy, removing only the obstructing hyperplastic tissue to alleviate lower urinary tract symptoms.^[11] Variants include open suprapubic (transvesical) approaches, which access the prostate through a bladder incision for enucleation of the adenoma, and retropubic methods that enter via the space anterior to the prostate; transurethral techniques, such as enucleation, offer a less invasive alternative for suitable anatomies but are distinguished from transvesical open surgery by avoiding abdominal incisions.^[12]^[13] Radical prostatectomy, the standard curative surgery for localized prostate cancer, involves complete removal of the prostate gland, seminal vesicles, and frequently pelvic lymph nodes to achieve oncologic control.^[10] This en bloc resection addresses malignant indications by excising the entire organ and adjacent tissues at risk of microscopic spread, often incorporating nerve-sparing techniques to preserve erectile function and urinary continence where tumor location permits.^[14]^[15] Partial or focal prostatectomy represents an emerging strategy for low-risk, localized prostate cancers, focusing on resecting only the tumor-bearing regions—such as in hemi-prostatectomy for unilateral disease—to minimize functional morbidity while achieving cancer control.^[16] Recent systematic reviews and studies up to 2025 have validated its feasibility for favorable and intermediate-risk cases with confined tumors, reporting comparable short-term oncologic outcomes to radical approaches in select patients, though long-term data remain limited.^[17]

Clinical Applications

Indications for Benign Conditions

Prostatectomy is primarily indicated for benign prostatic hyperplasia (BPH), a non-malignant enlargement of the prostate gland that leads to lower urinary tract symptoms (LUTS), including urinary obstruction, increased frequency, urgency, and nocturia. These symptoms arise from mechanical compression of the urethra by the enlarged prostate, impairing bladder emptying and causing significant quality-of-life disruptions in affected men. Surgical intervention, such as simple prostatectomy, is recommended when BPH-related LUTS are moderate to severe and persistent, particularly after assessment using validated tools like the International Prostate Symptom Score (IPSS).^[18]^[19] Absolute indications for prostatectomy in benign conditions include complications directly attributable to BPH-induced obstruction, such as acute or refractory urinary retention that does not respond to catheterization or medical management, recurrent urinary tract infections (UTIs), gross hematuria, formation of bladder stones, and hydronephrosis or renal insufficiency secondary to chronic bladder outlet obstruction. These scenarios necessitate surgical relief to prevent further renal damage, sepsis from infections, or ongoing bleeding. For instance, recurrent UTIs occur due to incomplete bladder emptying, fostering bacterial growth, while bladder stones form from urinary stasis.^[18]^[19] Prostatectomy is also warranted when conservative or medical treatments fail to alleviate symptoms. Initial management typically involves watchful waiting or pharmacotherapy, such as alpha-blockers (e.g., tamsulosin) to relax prostate smooth muscle or 5-alpha reductase inhibitors (e.g., finasteride) to reduce prostate volume, but surgery is indicated if LUTS remain bothersome despite 3-6 months of optimal therapy or if patients are unwilling to continue medications due to side effects. Similarly, failure of minimally invasive therapies like transurethral resection of the prostate (TURP) may prompt more definitive procedures such as open or robotic simple prostatectomy.^[18]^[19] Patient selection for prostatectomy emphasizes those typically aged over 50-60 years, as BPH prevalence increases with age, alongside prostate volumes exceeding 30-80 grams, depending on the surgical technique—smaller glands may suit endoscopic approaches, while larger ones (>80g) favor enucleation methods. Comorbidities, overall health status, and patient preferences guide final decisions, ensuring surgery addresses symptomatic BPH without overlooking potential contraindications like undiagnosed malignancy.^[18]^[19]

Indications for Malignant Conditions

Radical prostatectomy serves as a primary curative treatment for localized prostate cancer, particularly in cases confined to the prostate (clinical stages T1-T2) or extending locally (T3), where the goal is to achieve oncologic control through complete tumor resection.^[20] It is most commonly indicated for intermediate- and high-risk disease, defined by factors such as Gleason score (International Society of Urological Pathology Grade Groups 2-5), prostate-specific antigen (PSA) levels above 10 ng/mL, and clinical T-stage.^[21] For intermediate-risk patients, including favorable (Grade Group 2, PSA <10 ng/mL, T1-T2b) and unfavorable (Grade Group 3, PSA 10-20 ng/mL, T2b-T2c) subgroups, radical prostatectomy offers a survival benefit over watchful waiting, with hazard ratios indicating reduced all-cause mortality (e.g., overall HR 0.84 in the PIVOT trial, with HR 0.68 for intermediate-risk patients).^[20] In low-risk prostate cancer (Grade Group 1, PSA <10 ng/mL, T1-T2a), active surveillance is typically preferred to avoid overtreatment, but radical prostatectomy may be indicated if disease progression is detected on monitoring or based on patient preference for definitive intervention, especially in those with longer life expectancies.^[21] For high-risk cases (Grade Group 4-5, PSA >20 ng/mL, T2c-T3), surgery is pursued as part of a multimodal approach, often combined with adjuvant radiation or androgen deprivation therapy to address microscopic extracapsular extension or positive margins.^[20] The procedure's role in very high-risk disease (T3b-T4 or PSA >40 ng/mL) is more selective, reserved for patients without distant metastases where cytoreduction may enhance systemic therapy efficacy.^[21] Organ-confined or locally advanced disease must be confirmed through multiparametric MRI for local staging, systematic and targeted biopsy for Gleason grading and core involvement assessment, and, in intermediate- to high-risk cases, PSMA-PET/CT to evaluate for occult metastases or lymph node involvement, improving negative predictive value when integrated with MRI findings.^[20] Pelvic lymph node dissection is routinely included during radical prostatectomy for staging in intermediate- and high-risk patients (e.g., PSA >10 ng/mL or Gleason ≥7), particularly if nomogram-estimated risk of nodal invasion exceeds 5%, to guide adjuvant decisions and detect micrometastases in up to 21% of cases.^[20]^[21] According to 2025 guidelines from the European Association of Urology and National Comprehensive Cancer Network, radical prostatectomy is preferentially recommended for younger patients (typically under 70-75 years) with good performance status, low comorbidity burden, and a life expectancy exceeding 10 years, as these factors correlate with improved oncologic outcomes and functional recovery.^[20]^[21] Life expectancy is assessed using tools like the G8 geriatric screening or comprehensive evaluation, ensuring the benefits of surgery outweigh risks in frail or elderly individuals.^[20]

Contraindications

Prostatectomy, whether radical for cancer treatment or simple for benign conditions, carries specific contraindications that must be evaluated preoperatively to ensure patient safety and optimal outcomes. Absolute contraindications preclude surgery due to unacceptably high risks of morbidity or mortality, while relative contraindications allow for individualized assessment based on overall health and disease extent.^[22] For radical prostatectomy, absolute contraindications include metastatic prostate cancer (M1 disease), as surgery offers no curative benefit in such cases and is reserved for localized disease.^[22] Severe comorbidities that prevent tolerance of general anesthesia, such as uncontrolled heart failure, severe valvular disease, or high cardiac risk profiles, also constitute absolute barriers due to elevated perioperative mortality.^[23] Similarly, coagulation disorders or bleeding diatheses that cannot be corrected, along with an Eastern Cooperative Oncology Group (ECOG) performance status greater than 2 or life expectancy under 10 years, render the procedure inadvisable.^[23]^[22] Active peritoneal inflammatory processes, including untreated urinary tract infections, further prohibit surgery to avoid exacerbating systemic complications.^[22] Relative contraindications for radical prostatectomy encompass factors that increase technical difficulty or complication rates but may not entirely preclude intervention. Morbid obesity (body mass index >40) complicates access and pneumoperitoneum in minimally invasive approaches, often necessitating weight optimization prior to surgery.^[22] Extensive prior pelvic or abdominal surgery can lead to adhesions, heightening risks of bowel injury or conversion to open procedure.^[22] Locally advanced disease, such as T4 tumors or lymph node-positive (N1) status without neoadjuvant therapy, is relatively contraindicated for radical intent, as it typically warrants multimodal or alternative local therapies.^[4] Very large prostate volumes exceeding 200 grams pose challenges for certain minimally invasive techniques, potentially favoring open approaches.^[24] In the context of simple prostatectomy for benign prostatic hyperplasia, confirmed prostate cancer is an absolute contraindication, necessitating preoperative biopsy to exclude malignancy before proceeding.^[25] Relative contraindications mirror those for radical procedures, including severe cardiopulmonary conditions intolerant of steep Trendelenburg positioning in robotic or laparoscopic variants, and prior pelvic surgeries causing adhesions.^[26] As of 2025, advanced imaging like prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has become integral to preoperative evaluation, enhancing detection of extracapsular extension or occult metastases that could elevate these contraindications and guide toward nonsurgical options.^[27]^[28] This modality's high specificity for nodal staging and extraprostatic disease supports its routine use in intermediate- to high-risk cases to refine surgical candidacy.^[29]

Surgical Techniques

Open Approaches

Open approaches to prostatectomy involve traditional surgical techniques that utilize larger incisions to provide direct access to the prostate gland, primarily for radical or simple procedures in cases of prostate cancer or benign prostatic hyperplasia (BPH). These methods, developed in the early 20th century, prioritize en bloc removal of the prostate while allowing for meticulous dissection under direct visualization.^[25] Despite the advent of minimally invasive alternatives, open approaches remain relevant for complex cases, such as those involving large prostates or prior pelvic surgeries.^[1] The retropubic approach is the most commonly employed open technique for radical prostatectomy, involving a lower midline incision from the umbilicus to the pubic symphysis to access the prostate through the space of Retzius, an avascular plane anterior to the bladder.^[30] This method facilitates complete mobilization of the prostate, preservation of neurovascular bundles when possible, and simultaneous pelvic lymph node dissection, which is essential for staging in intermediate- or high-risk prostate cancer.^[31] It is particularly suited for tumors with potential extracapsular extension due to the broad exposure it provides.^[25] In contrast, the perineal approach employs an incision in the perineum between the scrotum and anus, offering quicker access to the prostate apex and shorter operative times compared to retropubic methods, often completing in under 3 hours.^[32] However, it carries a higher risk of postoperative urinary incontinence due to potential disruption of the external sphincter, and limits access to pelvic lymph nodes, precluding routine dissection.^[31] This technique is typically reserved for patients with localized disease and contraindications to abdominal entry.^[25] The suprapubic approach, primarily used for simple prostatectomy in BPH with glands exceeding 80 grams, involves an extraperitoneal incision into the anterior bladder wall to enucleate the hyperplastic adenoma, leaving the prostate capsule intact.^[25] Described by Eugene Fuller in 1895, it enables efficient removal of large adenomas through digital or instrumental enucleation, with the bladder incision closed over a suprapubic catheter post-procedure.^[33] This method is advantageous for massive BPH where transurethral approaches may be infeasible.^[25] Overall, open approaches offer superior direct visualization for managing bulky pathology or adhesions, making them ideal for glands larger than 100 grams or in obese patients.^[25] However, they are associated with greater intraoperative blood loss, typically ranging from 500 to 1000 mL, necessitating routine transfusion in 10-20% of cases, and prolonged recovery periods of 4-6 weeks before resuming normal activities.^[1]

Minimally Invasive Approaches

Minimally invasive approaches to prostatectomy, including laparoscopic and robotic-assisted techniques, utilize small incisions and advanced visualization to remove the prostate gland with reduced trauma compared to traditional methods. Laparoscopic prostatectomy involves inserting small instruments through several abdominal ports, typically five, under camera guidance to perform the procedure. This can be conducted as a pure laparoscopic approach, relying entirely on laparoscopic tools, or hand-assisted, where the surgeon's hand is inserted through a small incision for added tactile feedback. These methods enable precise dissection while minimizing tissue disruption, resulting in reduced intraoperative blood loss, commonly ranging from 200 to 500 mL.^[34]^[35] Robotic-assisted laparoscopic prostatectomy (RALP), most commonly performed using the da Vinci surgical system, enhances these benefits through magnified three-dimensional visualization, tremor filtration to eliminate hand tremors, and articulated instruments that mimic human wrist movements for greater dexterity. The surgeon operates from a console, directing robotic arms while a bedside team manages port placement and patient positioning. By 2025, advancements such as single-port RARP, which uses a single umbilical incision for all instruments to further reduce scarring and pain, and Retzius-sparing techniques, which preserve anterior support structures to improve early urinary continence recovery rates to 80-93% at 12 months, have become more widely adopted.^[36]^[37]^[5] The general procedure for these approaches begins with establishing pneumoperitoneum via insufflation of carbon dioxide to create working space in the abdominal cavity, followed by port placement for instruments and camera. Key steps include posterior dissection to access the seminal vesicles and vas deferens, development of the plane between the prostate and rectum, nerve-sparing dissection to preserve erectile function when possible, and completion of the urethrovesical anastomosis using sutures to reconnect the bladder to the urethra. A catheter is placed postoperatively, with typical hospital stays of 1-2 days due to accelerated recovery.^[37]^[38] Outcomes of minimally invasive prostatectomy demonstrate lower overall complication rates, around 10-12%, including reduced bleeding and infection risks, alongside faster return to normal function such as ambulation within hours and continence recovery in 70-90% of patients by 3-6 months. Surgeon experience plays a pivotal role, with optimal results—such as minimized positive surgical margins and operative times—achieved after approximately 300-500 cases, underscoring the importance of high-volume centers.^[39]^[40]^[41]

Specialized Techniques

Holmium laser enucleation of the prostate (HoLEP) is an endoscopic technique utilizing a holmium:YAG laser to enucleate and remove hyperplastic prostate tissue in patients with benign prostatic hyperplasia (BPH), followed by morcellation to extract the tissue through the urethra. This method is particularly effective for large prostates exceeding 80 grams, where it demonstrates superior durability compared to traditional transurethral resection of the prostate (TURP), with excellent functional outcomes including improved urinary flow rates and low complication rates. In a randomized controlled trial, HoLEP achieved a reoperation rate of 0% at 7 years for symptom recurrence, contrasting with 18% for TURP, highlighting its long-term efficacy in reducing the need for repeat interventions.^[42] Thulium laser vaporization and green-light laser photoselective vaporization of the prostate (PVP) represent less invasive alternatives to HoLEP, primarily suited for smaller prostate glands in BPH management. Thulium laser procedures enable precise vaporization or vaporesection of tissue, often performed in an outpatient setting with minimal bleeding and rapid recovery, making them ideal for patients with comorbidities or those seeking shorter hospital stays. Similarly, green-light PVP uses a 532 nm laser to vaporize excess tissue while coagulating vessels, allowing for outpatient treatment in many cases and providing symptom relief comparable to TURP with fewer perioperative complications. Both techniques yield durable improvements in lower urinary tract symptoms for prostates typically under 80 grams, though they may require longer operative times for optimal tissue removal.^[43]^[44]^[45] Partial prostatectomy has emerged as a focal therapy option in 2025 for low-risk, localized prostate cancer, employing robotic assistance to target and remove only the tumor-bearing portion of the gland while preserving surrounding healthy tissue. This approach, often via single-port robotic transvesical access, minimizes functional deficits compared to radical prostatectomy and is feasible in carefully selected patients with confined disease. Emerging clinical studies suggest promising short-term oncologic and functional outcomes, with preserved quality of life metrics such as continence and potency, though long-term comparative data against radical procedures are limited.^[46]

Complications and Risks

Perioperative Complications

Perioperative complications of prostatectomy encompass risks arising during surgery and in the immediate postoperative period, typically within 30 days. These can include intraoperative events such as excessive bleeding and organ injuries, as well as postoperative issues like infections and thromboembolic events. Overall complication rates have declined with advancements in surgical techniques, particularly robotic-assisted approaches, which offer improved visualization and precision.^[47] Intraoperative bleeding remains the most common complication during radical prostatectomy, often necessitating blood transfusion in 1-2% of cases overall. Transfusion rates are notably lower with robotic-assisted radical prostatectomy (RARP) at approximately 0.8%, compared to 3.4% for open retropubic radical prostatectomy (RRP).^[48] Rectal injury occurs in about 0.58% of procedures across all approaches, with higher incidence in open surgery (1.25%) versus RARP (0.08%).^[49] Ureteral injury is less frequent, affecting fewer than 1% of patients, typically managed through stenting or repair during surgery.^[50] Postoperative infections, including urinary tract infections (UTIs) and wound infections, affect 5-10% of patients following prostatectomy. UTI rates are around 6.1% within 30 days after robotic procedures, often linked to catheterization, while superficial surgical site infections occur in 2-6% of cases.^[51]^[52] Lymphocele formation, especially following pelvic lymph node dissection in robotic procedures, occurs in 1-10% of symptomatic cases and may require drainage if complicated.^[53] Deep vein thrombosis (DVT) can develop in 20-40% of patients without thromboprophylaxis, but rates are reduced to 1-3% with standard perioperative measures including heparin administration.^[54]^[55] Pulmonary embolism (PE) is rarer, occurring in less than 1% of cases, though it carries significant morbidity if untreated.^[56] Cardiac events, such as myocardial infarction or arrhythmias, are infrequent overall (about 2%) but more prevalent in high-risk patients with preexisting cardiovascular disease.^[57] Perioperative mortality is low, at less than 0.3% overall, influenced by factors including patient comorbidities and anesthesia risks. Rates are higher with open approaches (approximately 0.5%) compared to robotic (0.1%), reflecting differences in surgical stress and recovery.^[47] Long-term studies up to 2025 indicate further reductions in these rates with widespread adoption of RARP, attributed to minimized blood loss and shorter operative times.^[58] Prophylactic measures, such as antibiotics for infection prevention, are integral to management and detailed in subsequent sections.

Functional Complications

Functional complications following prostatectomy primarily affect urinary, sexual, and reproductive functions, persisting beyond the immediate postoperative period and impacting quality of life. These deficits arise from disruption to the sphincteric mechanisms, neurovascular bundles, and seminal structures during surgery, with rates varying by technique and patient factors. Urinary incontinence, predominantly stress type due to external sphincter damage, occurs in 9-16% of patients long-term (12-24 months post-surgery).^[59] Rates are higher with open or perineal approaches (up to 20%) compared to robotic-assisted methods (5-10%), reflecting improved precision in preserving continence mechanisms.^[60] Erectile dysfunction affects over 50% of men after radical prostatectomy, stemming from cavernous nerve injury, with recovery influenced by age, preoperative function (assessed via SHIM score), and surgical extent.^[61] Nerve-sparing techniques reduce this risk to 30-50%, particularly in younger patients with strong baseline erectile function (SHIM >21).^[61] Reproductive function is severely compromised, with anejaculation occurring in all cases of radical prostatectomy due to removal of the prostate and seminal vesicles, rendering natural conception impossible.^[62] Simple prostatectomy may cause retrograde ejaculation instead, but testosterone levels remain unaffected as testicular production persists.^[62] Other functional issues include urethral stricture (incidence 2-10%) and bladder neck contracture (0-7.5%), resulting from anastomotic healing disruptions and more common after open procedures.^[63]^[64]

Management Strategies

Management of complications following prostatectomy emphasizes targeted interventions to address urinary incontinence and erectile dysfunction (ED), the most common functional issues. For post-prostatectomy urinary incontinence, initial conservative management involves pelvic floor muscle exercises, commonly known as Kegel exercises, which strengthen the pelvic floor to improve continence. A meta-analysis of randomized controlled trials demonstrated that structured pelvic floor muscle training programs, consisting of at least three sets of 10 repetitions daily, significantly enhance continence rates, with relative risk improvements ranging from 1.23 to 2.16 across short-, medium-, and long-term follow-up periods.^[65] These exercises yield continence in approximately 60-80% of patients when initiated early, though outcomes vary based on adherence and supervision.^[66] For patients with persistent mild to moderate incontinence despite conservative measures, surgical options include male slings, which provide mechanical support to the urethra. Transobturator male slings achieve success rates of around 77% at 1 year, defined as no pads or minimal leakage, with low rates of severe complications.^[67] In cases of severe incontinence, the artificial urinary sphincter (AUS) remains the gold standard, offering high patient satisfaction rates of 90%, even if complete dryness is not always attained.^[68] Implantation of the AUS involves placing an inflatable cuff around the urethra, controlled by a pump, and is associated with durable long-term results in appropriately selected patients.^[69] Erectile dysfunction, affecting up to 80% of patients post-prostatectomy, is managed through penile rehabilitation protocols aimed at preserving penile tissue oxygenation and promoting nerve recovery. Phosphodiesterase type 5 (PDE5) inhibitors, such as sildenafil, form the cornerstone, with response rates of 50-70% in achieving erections sufficient for intercourse when initiated early after catheter removal.^[70] Adjunctive therapies include vacuum erection devices, which facilitate blood flow and are effective in 60-80% of users for maintaining penile length and function, and intracavernosal injections, offering reliable erections in over 90% of attempts but requiring patient training.^[71] Emerging evidence supports low-intensity extracorporeal shockwave therapy (LI-ESWT) as an adjunct, with preliminary 2025 studies indicating improved erectile function scores in 50-70% of post-prostatectomy patients when applied early, though larger trials are needed to confirm efficacy.^[72] Surgical revisions address specific structural complications, such as anastomotic strictures, which occur in 5-15% of cases and can exacerbate incontinence. Endoscopic dilation or incision provides initial relief with success rates of 40-60% at 1 year, often requiring repeat procedures due to recurrence.^[73] For ED related to nerve damage, sural nerve grafts have been explored but demonstrate limited efficacy, with recovery rates below 30% in most series and are not routinely recommended due to insufficient evidence.^[74] A multidisciplinary approach optimizes outcomes, involving collaboration between urologists, pelvic floor rehabilitation specialists, and psychologists to tailor interventions. Patient education on realistic expectations, such as gradual recovery over 12-24 months, enhances adherence and satisfaction, as supported by American Urological Association guidelines.^[75]

Recovery and Aftercare

Immediate Postoperative Care

Following radical prostatectomy, patients typically remain in the hospital for 1 to 3 days after minimally invasive procedures such as robotic-assisted or laparoscopic approaches, during which vital signs are closely monitored and any postoperative bleeding is assessed through drainage output and urine color.^[1] In contrast, open prostatectomy often requires a 3- to 5-day stay to allow for stabilization and observation of potential complications like excessive bleeding or hemodynamic instability.^[76]^[77] During this phase, patients are watched for signs of perioperative infections, such as fever exceeding 101°F or wound redness, prompting immediate intervention.^[78]^[79] Enhanced recovery after surgery (ERAS) protocols, implemented as standard in many centers as of 2025, emphasize multimodal strategies including early mobilization, optimized pain control, and nutritional support to accelerate recovery and reduce complications.^[80] A key aspect of immediate care involves management of an indwelling Foley catheter, which is placed during surgery and remains for 7 to 14 days to facilitate bladder healing and urine drainage while preventing anastomotic strictures.^[1]^[79] The catheter bag must be kept below bladder level to ensure proper flow, and gentle irrigation with sterile saline may be performed if clots obstruct drainage, reducing the risk of urinary retention.^[79] In robotic-assisted cases, early catheter removal—often within 1 to 7 days—is feasible due to precise anastomotic techniques, provided cystography confirms no leaks.^[81]^[82] Patients are instructed to clean the catheter site daily with soap and water to minimize infection risk.^[79] Pain control begins with intravenous or oral opioids in the recovery room for moderate to severe incisional or pelvic discomfort, transitioning to non-opioid analgesics like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) within 24 to 48 hours to promote comfort while minimizing side effects such as constipation.^[83]^[84] Multimodal regimens, including scheduled NSAIDs, align with evidence-based guidelines to reduce overall opioid use by up to 75% postoperatively.^[83]^[85] Dietary progression starts with clear liquids on the day of surgery to assess tolerance, advancing to soft solids as bowel function resumes, with emphasis on high-fiber intake and stool softeners like docusate to prevent straining and constipation.^[79]^[1] Patients are encouraged to drink 6 to 8 glasses of water daily to maintain hydration and support catheter patency.^[79] Early ambulation is initiated within 4 hours of surgery, with patients walking multiple times daily to enhance circulation and reduce thromboembolic risk.^[79] Deep vein thrombosis (DVT) prophylaxis typically includes sequential compression devices during the hospital stay and early mobilization for all patients, with low-molecular-weight heparin added for those at elevated risk per current perioperative venous thromboembolism guidelines (e.g., 2024 European Society of Anaesthesiology and Intensive Care).^[86]^[79]

Long-term Management

Following radical prostatectomy, patients undergo regular follow-up to monitor for disease recurrence and manage potential long-term effects. Current EAU guidelines (2025) recommend confirming an undetectable prostate-specific antigen (PSA) level around 2 months postoperatively, followed by PSA testing every 6 months for the first 3 years and annually thereafter, with frequency tailored to initial risk group, life expectancy, and patient preferences—more frequent for higher-risk cases.^[87] Annual digital rectal examinations (DRE) may also be advised as part of ongoing surveillance to detect any local abnormalities, though their utility is limited if PSA remains undetectable.^[87] Lifestyle adjustments play a key role in long-term recovery and quality of life. Patients are encouraged to continue pelvic floor (Kegel) exercises indefinitely to support urinary continence, with studies showing improved outcomes when performed consistently beyond the initial postoperative period. A high-fiber diet is recommended to promote bowel health and prevent constipation, which can exacerbate pelvic floor strain; examples include incorporating fruits, vegetables, and whole grains while staying hydrated. Heavy lifting should be avoided for the first 4 to 6 weeks after discharge to reduce risks of hernia or wound disruption, transitioning to gradual resumption of normal activities under medical guidance.^[88]^[89] Sexual health counseling is integral to long-term management, addressing common challenges like erectile dysfunction and infertility. Patients are typically advised to resume sexual activity after 4 to 6 weeks, once healing is confirmed, with options like phosphodiesterase-5 inhibitors or vacuum devices offered for support. Preoperative counseling on fertility preservation, such as sperm banking, is emphasized for men desiring future fatherhood, as prostatectomy results in infertility due to absence of semen production.^[90]^[62] Surveillance for recurrence focuses primarily on biochemical indicators, with a rising PSA level signaling potential biochemical recurrence (defined as two consecutive PSA values ≥0.2 ng/mL). In such cases, additional imaging like multiparametric MRI or PSMA-PET/CT is pursued if it would influence treatment decisions, such as salvage therapy. Ongoing management of incontinence, including continued Kegel exercises, may be referenced from prior strategies to maintain function.^[91]^[87]

Outcomes and Epidemiology

Clinical Outcomes

Clinical outcomes following prostatectomy, particularly radical prostatectomy for localized prostate cancer, demonstrate high rates of cancer control, with 5-year biochemical recurrence-free survival ranging from 80% to 95% in patients with organ-confined disease.^[92]^[93] This oncologic efficacy is supported by long-term data showing 10-year overall survival exceeding 90% for similar low- to intermediate-risk cohorts, reflecting effective local tumor removal and low rates of prostate cancer-specific mortality.^[94]^[95] Functional recovery post-prostatectomy focuses on urinary continence and erectile function, with the majority of patients achieving favorable results over time. Urinary continence returns in 85% to 95% of patients by 12 months postoperatively, often aided by nerve-sparing techniques that minimize disruption to pelvic floor innervation.^[96]^[75] Erectile potency preservation varies but reaches 40% to 70% in men undergoing bilateral nerve-sparing procedures, particularly when preoperative function is intact and younger age is a factor.^[97]^[98] Quality-of-life assessments using validated instruments like the Expanded Prostate Cancer Index Composite-26 (EPIC-26) reveal domain-specific changes after prostatectomy. Scores in the urinary irritative/obstructive domain typically improve due to relief from preoperative lower urinary tract symptoms, while the sexual domain experiences a notable decline, reflecting persistent challenges with erectile function despite recovery efforts.^[99]^[100] The urinary incontinence domain shows initial worsening followed by substantial recovery aligning with continence rates.^[101] As of 2025, advancements in artificial intelligence have introduced pathology-based multimodal AI biomarkers that enhance outcome prediction following radical prostatectomy. These models, analyzing digital histopathology slides, accurately stratify recurrence risk, with external validations demonstrating superior performance over traditional clinical tools in forecasting 10-year metastasis-free survival and biochemical recurrence.^[102]^[103] For instance, such AI systems have reported 74% recurrence-free survival at 10 years in validated cohorts, aiding personalized postoperative surveillance.^[104]

Epidemiological Trends

In the United States, approximately 83,000 radical prostatectomies were performed in 2022, reflecting a continued decline from peaks of over 100,000 in the mid-2000s due to the growing adoption of nonsurgical alternatives such as active surveillance and radiation therapy.^[105]^[106] The median age of patients undergoing prostatectomy is 62 years, with about 80% of procedures occurring in men over 60 years old, aligning with the typical age distribution of localized prostate cancer diagnoses amenable to surgery.^[107]^[108] Historical trends in prostatectomy utilization show a sharp rise following the widespread introduction of prostate-specific antigen (PSA) screening in the late 1980s and 1990s, which increased early detection and drove procedure volumes to their zenith around 2000–2005; rates have since stabilized and modestly declined amid PSA screening controversies and the promotion of active surveillance for low- and intermediate-risk cases, reducing overtreatment.^[109] Utilization remains higher in high-income countries compared to low- and middle-income regions, where access to advanced surgical care and screening is limited.^[110] Racial and ethnic disparities persist in prostatectomy epidemiology, with Black men experiencing a higher prostate cancer incidence rate—approximately 70% greater than White men—but undergoing radical prostatectomy at similar or slightly lower rates, potentially due to barriers in access to care, preferences for alternative treatments, or differences in disease aggressiveness at diagnosis.^[111]^[108] Additionally, surgeon experience plays a critical role in outcomes, as those performing more than 100 cases per year achieve 20–30% reductions in complication rates compared to lower-volume surgeons, underscoring the importance of centralized care in high-volume centers.^[112] In 2025, these trends align with prostate cancer accounting for about 30% of all new male cancer diagnoses in the US (313,780 estimated cases), though prostatectomy is utilized in only around 20–30% of those cases, reflecting a shift toward conservative management.^[113]^[108]

Historical Development

Early Procedures

The earliest intentional prostatectomies emerged in the late 19th century as surgeons sought to address severe benign prostatic hyperplasia (BPH), which caused urinary obstruction and recurrent infections. In 1886, William T. Belfield in Chicago conducted the first purposeful suprapubic enucleation for BPH, removing a portion of the median lobe through a suprapubic cystotomy, which allowed bladder access but introduced risks of urinary extravasation.^[114] Five years later, in 1891, George E. Goodfellow of Tucson, Arizona, performed the first planned perineal prostatectomy, enucleating both lateral and median lobes of an enlarged prostate adenoma through a perineal incision, marking a deliberate shift from incidental excisions during lithotomy procedures.^[114] This approach aimed to provide direct access to the prostate while avoiding abdominal entry, though it was initially limited by poor visualization and reliance on digital enucleation. Early procedures faced formidable challenges in the pre-antibiotic era, with mortality rates ranging from 20% to 50% primarily due to postoperative infections, sepsis, and uncontrollable bleeding from incomplete hemostasis.^[115] Blind enucleation techniques often led to capsular tears and residual adenoma, exacerbating hemorrhage, while inadequate antiseptic practices amplified infection risks in hospital settings. In 1903, Hugh Hampton Young refined perineal approaches by introducing a prostatic tractor for improved visualization and control during enucleation, building on Goodfellow's method to reduce immediate postoperative complications, though incontinence remained a concern due to proximity to the urethral sphincter.^[114] These refinements helped lower perineal mortality to under 10% in select series, but overall operative risks deterred widespread adoption for anything beyond straightforward BPH cases.^[116] The advent of radical prostatectomy for prostate cancer also began in this era, with Hugh Hampton Young performing the first successful perineal radical procedure in 1904 at Johns Hopkins, removing the entire prostate and surrounding tissues; however, early attempts faced near-total mortality from sepsis and incontinence in the absence of antibiotics.^[117] By the mid-20th century, advancements addressed some limitations of suprapubic and perineal routes. In 1945, Terence Millin in London standardized the retropubic prostatectomy, accessing the prostate extravesically through the retropubic space, suturing the prostatic capsule for hemostasis, and using urethral catheterization for drainage, which significantly reduced infection and bleeding complications compared to prior methods.^[118] This technique achieved mortality rates below 5% in experienced hands by minimizing bladder opening and improving drainage.^[118] In the absence of antibiotics until the late 1940s, surgeons prioritized simple enucleations for BPH to avoid the prohibitive risks of radical excisions for malignancy, which often resulted in near-total mortality from sepsis and incontinence.^[114]

Modern Innovations

In 1982, Patrick Walsh pioneered the nerve-sparing radical prostatectomy technique, which involves careful preservation of the cavernous nerves responsible for erectile function during prostate removal.^[119] This innovation marked a significant advancement over prior methods, improving postoperative potency rates while maintaining oncologic efficacy.^[120] The early 2000s saw the introduction of robotic-assisted radical prostatectomy (RARP), facilitated by the da Vinci Surgical System, which received FDA approval in 2000 for use in general laparoscopic procedures including prostatectomy.^[121] This system enhanced surgical precision through three-dimensional visualization and articulated instruments, reducing blood loss and hospital stays compared to open surgery.^[122] By 2010, RARP had achieved over 80% adoption for radical prostatectomies in the United States, reflecting rapid integration into clinical practice.^[123] Globally, prostatectomy techniques have shifted dramatically from predominantly open procedures, which accounted for approximately 90% of cases in 1990, to minimally invasive approaches comprising about 85% by 2025.^[124] This evolution, driven by laparoscopic and robotic innovations, has led to decreased perioperative morbidity and faster recovery times worldwide.^[125] As of 2025, several cutting-edge advancements continue to refine RARP outcomes. Single-port RARP, utilizing systems like the da Vinci SP, enables access through a single incision, minimizing scarring and postoperative pain while achieving comparable oncologic results to multi-port techniques.^[80] Retzius-sparing RARP, which avoids dissection in the Retzius space to preserve urethral support structures, has demonstrated immediate urinary continence rates of 64-80% at 24 hours post-surgery, depending on prostate volume.^[126] Partial prostatectomy, targeting only the tumor-bearing portion of the gland, is gaining validation as a function-preserving option for select low-risk cases, with preliminary studies showing low recurrence rates and preserved quality of life.^[80] Additionally, AI-assisted planning integrates machine learning for preoperative imaging analysis and intraoperative augmented reality guidance, improving nerve-sparing accuracy and reducing positive surgical margins.^[127]

Economic Considerations

Costs in the United States

The average total cost of a prostatectomy in the United States as of 2025 ranges from $15,000 to $42,000, depending on the procedure type and facility.^[128]^[129] For robotic-assisted radical prostatectomy, costs typically fall between $14,000 and $40,000, while traditional open procedures range from $8,000 to $20,000 or more.^[130] Hospital and facility fees account for the largest portion, averaging $10,000 to $35,000, with physician fees ranging from $4,000 to $18,000.^[128] For patients paying cash or self-pay, options through platforms like MDsave offer more affordable bundled pricing, with radical prostatectomy costs between $12,000 and $15,600 and robotic variants from $16,000 to $25,900.^[131]^[132] Individuals with insurance often face out-of-pocket copayments of 10% to 20% of the total after meeting their deductible, though Medicare beneficiaries typically pay the Part A inpatient hospital deductible of $1,676 in 2025 for prostatectomy, with no copayments for hospital stays up to 60 days.^[133]^[134]^[128] Several factors influence these costs. Robotic-assisted procedures incur a premium of at least $5,000 over open surgery, primarily due to equipment and instrumentation expenses, though overall health care use may be lower with robotics.^[135] Costs are higher in urban areas, particularly in non-teaching hospitals, compared to rural or teaching facilities, with regional variations showing elevated prices in the West and Northeast.^[136]^[135] Complications can increase expenses by 20% to 50%, as medical events like infections or readmissions add $1,700 to $4,800 per incident.^[137]^[138] Long-term costs beyond the initial surgery include approximately $19,000 in additional expenses over five years (as of 2018 data) for monitoring, follow-up treatments, and management of side effects like incontinence or erectile dysfunction.^[139] These follow-up costs contribute to a cumulative five-year total of around $46,000 per patient for localized prostate cancer care involving prostatectomy (as of 2018).^[139] In 2025, Medicare Part D introduces an annual out-of-pocket cap of $2,000 for prescription drugs, which may reduce costs for medications related to side effect management.^[134]

International Variations

In Europe, the cost of Holmium Laser Enucleation of the Prostate (HoLEP) or robotic-assisted prostatectomy typically ranges from €7,000 to €15,000, depending on the procedure and facility, with a specific example of €7,590 for HoLEP in Spain through private providers.^[140]^[141] Universal healthcare systems across many European nations, such as those in Spain and the broader EU, cover a substantial portion of these expenses through government funding or mandatory insurance, significantly reducing out-of-pocket costs for patients.^[142] In Asia and the Middle East, prostatectomy costs generally fall between $5,000 and $12,000, influenced by lower labor and operational expenses, with HoLEP seeing increased adoption in regional clinics, including those in Jordan projecting similar pricing structures into 2025.^[143]^[144] For instance, HoLEP procedures in the UAE are quoted at around $6,800, reflecting the procedure's growing preference for its efficacy in treating benign prostatic hyperplasia.^[145] In developing countries, prostatectomy costs range from $2,000 to $8,000, often favoring open surgical approaches due to limited access to advanced technologies; robotic systems, which require investments exceeding $1 million, remain prohibitive barriers in resource-constrained settings.^[143]^[146] Access disparities are stark, with approximately 94% of individuals in low- and middle-income countries lacking timely surgical care compared to 14.9% in high-income nations, exacerbating inequities in prostate cancer management.^[147] As of 2025, emerging trends include the integration of telemedicine for preoperative planning and postoperative monitoring in prostatectomy care, which helps mitigate travel-related expenses and improves accessibility in underserved regions.^[148] According to WHO-aligned analyses and global health reports, surgical costs in low-income countries are about 50% lower than in high-income nations, though this comes at the expense of reduced availability of minimally invasive options like robotic procedures.^[149] These variations underscore broader global inequities, with costs in Europe and the US often exceeding those in Asia and developing regions by significant margins.^[150]

References

[1]
Prostatectomy (prostate removal surgery) - Mayo Clinic
Sep 19, 2025 · Overview. Prostatectomy is surgery to take out part or all of the prostate gland. The prostate gland is part of the male reproductive system. ...
[2]
Definition of prostatectomy - NCI Dictionary of Cancer Terms
Surgery to remove part or all of the prostate and some of the tissue around it, including the seminal vesicles (a gland that helps make semen).Missing: overview | Show results with:overview
[3]
Prostate Cancer Treatment - NCI
Dec 20, 2024 · Prostate cancer treatment can include active surveillance, surgery, radiation therapy, hormonal therapy, chemotherapy, immunotherapy, ...
[4]
Clinically Localized Prostate Cancer: AUA/ASTRO Guideline (2022)
Initial monitoring should in general be performed more frequently and is recommended every three to six months for the first two years after treatment.
[5]
Recent Advances in Radical Prostatectomy: A Narrative Review of ...
Mar 6, 2025 · Our research examines recent advancements in surgical techniques, such as robot-assisted procedures, aimed at effectively treating prostate cancer while ...
[6]
Prostate Imaging - StatPearls - NCBI Bookshelf - NIH
Jan 16, 2023 · The prostate is a "walnut-shaped gland, a part of the male reproductive system that produces and secretes thin alkaline fluid in the ejaculate.Prostate Imaging · Magnetic Resonance · Ultrasonography
[7]
Options for Curative Treatment of Localized Prostate Cancer - NIH
The established treatments with curative intent are radical prostatectomy, percutaneous radiotherapy, and brachytherapy, with active surveillance as a further ...
[8]
Benign Prostatic Hyperplasia - StatPearls - NCBI Bookshelf
Benign prostatic hyperplasia (BPH) refers to the nonmalignant growth or hyperplasia of prostate tissue and is a common cause of lower urinary tract symptoms ...Missing: simple | Show results with:simple
[9]
Simple prostatectomy: MedlinePlus Medical Encyclopedia
Apr 29, 2025 · Simple prostate removal is a procedure to remove the inside part of the prostate gland to treat an enlarged prostate.Missing: definition | Show results with:definition
[10]
Definition of radical prostatectomy - NCI Dictionary of Cancer Terms
Surgery to remove the entire prostate and some of the tissue around it, including the seminal vesicles (a gland that helps make semen).
[11]
Robot-assisted simple prostatectomy versus open simple ... - NIH
Mar 28, 2020 · Open simple prostatectomy (OSP) is a standard surgical technique for patients with benign prostatic hyperplasia with prostate size larger ...
[12]
Robotic Assisted Simple Prostatectomy versus Holmium Laser ... - NIH
Aug 24, 2023 · Both techniques showed excellent outcomes in improving LUTS/BPH. However, RASP costs are high, which puts a burden on the patient.
[13]
Open prostatectomy versus transurethral resection of the prostate ...
Open transvesical prostatectomy is an acceptable operation for the prostates sized 30 to 70 g. Higher peak flow rate improvement, better quality of life, ...
[14]
Radical prostatectomy: MedlinePlus Medical Encyclopedia
Jan 1, 2025 · Radical prostatectomy (prostate removal) is surgery to remove all of the prostate gland and some of the tissue around it. It is done to treat prostate cancer.
[15]
Radical Prostatectomy | UCSF Department of Urology
A radical prostatectomy is surgery to remove the prostate gland and seminal vesicles (and sometimes nearby lymph nodes) after a prostate cancer diagnosis.Missing: simple, | Show results with:simple,
[16]
Partial prostatectomy for localized prostate cancer - PubMed
Sep 27, 2024 · Partial prostatectomy is explored for localized prostate cancer treatment, aiming to balance cancer control with preserving function.
[17]
Partial prostatectomy in prostate cancer: a systematic review of ...
Sep 12, 2025 · With further research, partial prostatectomy may become an option for patients with favorable and intermediate-risk disease with unilateral ...
[18]
[PDF] BPH Surgical Management 062420.pub
The American Urological Association (AUA) Guideline: Management of Benign Prostatic Hyperplasia was last revised in 2010.1 In preparation for an update of the.
[19]
EAU Guidelines on the Management of Non-neurogenic Male LUTS
These EAU Guidelines offer practical evidence-based guidance on the assessment and treatment of men aged 40 years or older with various non-neurogenic ...Disease Management · Diagnostic Evaluation · References · Methods
[20]
[PDF] Prostate Cancer - Cloudfront.net
Standard procedure for EAU Guidelines includes an annual assessment of newly ... Recommendations for follow-up after radical prostatectomy or radiotherapy.
[21]
[PDF] NCCN Guidelines for Patients: Early-Stage Prostate Cancer
Prostate surgery. Prostate surgery (radical prostatectomy) removes the whole prostate. It's not a common treatment option for people with low-risk prostate ...
[22]
Perspective Chapter: Perioperative Considerations for Patients ...
Absolute and relative contraindications for robotic radical prostatectomy. At our institution, the pre-operative anesthetic assessment includes ...
[23]
Outcomes of Minimally Invasive Radical Prostatectomy–a ... - NIH
Bleeding diatheses and the inability to sustain general anesthesia due to high cardiac risk are the only absolute contraindication of minimally invasive RP.
[24]
Robot-Assisted Radical Prostatectomy: A Step-by-Step Guide - PMC
Radical prostatectomy remains an important means to treat prostate cancer. A major limiting factor to radical prostatectomy is short- and long-term ...Surgical Steps · Dvc And Urethral Transection · Hernia Repair
[25]
Simple Prostatectomy: Overview, Preparation, Technique
Dec 19, 2023 · Open (simple) prostatectomy is contraindicated in the presence of prostate cancer. If cancer is suspected, a formal prostate biopsy should be ...Overview · Preparation · TechniqueMissing: guidelines | Show results with:guidelines
[26]
Simple prostatectomy - Abdominal Key
Aug 8, 2022 · Contraindications to the minimally invasive simple prostatectomy include patients whose cardiopulmonary status cannot tolerate prolonged steep ...Patient Preoperative... · Trocar Placement · Mobilization Of The Bladder<|separator|>
[27]
Efficacy of [18F]PSMA-1007 PET/CT in Primary Staging of Prostate ...
Oct 23, 2025 · In terms of sensitivity for M staging on a patient level, [18F]PSMA-1007 PET/CT outperformed all other tested conventional imaging modalities.
[28]
Impact of 68Ga-PSMA PET/MRI on the Accuracy of MRI-Derived ...
Sep 22, 2025 · Objectives: Accurate preoperative staging and prediction of extraprostatic extension (EPE) are critical for optimal surgical planning in ...
[29]
DCFPyL Prostate-Specific Membrane Antigen Positron Emission ...
Oct 1, 2025 · Preoperative PSMA PET/CT provides high specificity and negative predictive value for nodal staging in intermediate-risk PCa, supporting the ...
[30]
Open retropubic radical prostatectomy - PMC - NIH
The goals of modern ORP are to remove the prostate en-bloc with negative surgical margins, while minimising blood loss and preserving urinary continence and ...Missing: simple, | Show results with:simple,
[31]
Surgery for Prostate Cancer | Prostatectomy
Nov 22, 2023 · Radical retropubic prostatectomy The catheter will usually stay in place for 1 to 2 weeks while you heal. You will be able to urinate on your ...
[32]
Radical perineal prostatectomy: An outdated procedure?
There are four approaches to perform this surgery: the retropubic technique and the perineal technique for open surgery, the laparoscopic technique, which is ...
[33]
Open suprapubic versus retropubic prostatectomy in the treatment of ...
Two open prostatectomy techniques have been described: the suprapubic (SP) and retropubic (RP) approaches are both widely performed all around the World (5).
[34]
LAPAROSCOPIC RADICAL PROSTATECTOMY: SINGLE CENTER ...
The median procedure duration was 196.8 minutes and median blood loss 257.1 mL. Significant decrease in both outcomes was observed when comparing first and ...
[35]
Robotic-assisted versus laparoscopic radical prostatectomy for ... - NIH
Apr 18, 2023 · In recent years, LRP has been recognised for its advantages of minimally invasive surgery in the treatment of PCa, such as reduced blood loss, ...
[36]
Outcomes of Robot-Assisted Laparoscopic Prostatectomy with ... - NIH
Robotic systems provide many advantages, including three-dimensional (3D) vision, enhanced magnification, tremor filtering, and motion scaling [8]. In addition, ...
[37]
Robotic radical prostatectomy: The new gold standard - PMC
The da Vinci system is a sophisticated master–slave robotic surgical device that incorporates three-dimensional (3D) high-definition visualisation, movement ...Missing: RALP | Show results with:RALP
[38]
Anesthesia considerations for robotic-assisted laparoscopic ... - NIH
Mean hospital stay is 1.2 days [11]. To enhance discharge readiness and to maintain functionality patients are encouraged to ambulate within a few hours of ...Missing: steps | Show results with:steps
[39]
Clinical outcomes and costs of robotic surgery in prostate cancer - NIH
The overall 3-year complication rates were 10.4%, 11.8%, and 10.4% in the RALP, LRP, and RRP groups, respectively. The most common complications included ...
[40]
A systematic review and meta-analysis of randomized control trials
Apr 27, 2025 · Minimally invasive surgery reduces blood loss and transfusions vs. open surgery. Fewer complications occur with minimally invasive than with ...
[41]
Real-time assessment of learning curve for robot-assisted ... - NIH
It takes about 300 cases and nearly 4 years to standardise operative and console times, with a requirement of around 80 cases per annum for a single surgical ...Missing: optimal | Show results with:optimal
[42]
HoLEP: the gold standard for the surgical management of BPH ... - NIH
Kuntz et al in 2008 also reported a reoperation rate of zero at 5 years for men with prostates > 100 g who underwent HoLEP.
[43]
V02-06: Transurethral Thulium Laser Prostatectomy in the ...
Apr 2, 2019 · Our experience suggests that thulium laser vaporization of the prostate is a safe, effective and durable alternative for the treatment of BPH ...Missing: smaller | Show results with:smaller
[44]
Prostate laser surgery - Mayo Clinic
a condition known as benign ...Missing: definition | Show results with:definition
[45]
GreenLight Laser PVP | Urology & Prostate Cancer Physician ...
GreenLight™ Laser PVP is an outpatient procedure performed by a urologist with specialized training in the technique. The anesthesia can be general, spinal, or ...
[46]
Single-Port Robotic Transvesical Partial Prostatectomy: A Novel ...
Feb 5, 2025 · Conclusions: SP-TVRAPP represents a promising treatment for certain patients with localized prostate cancer. This targeted surgical method has ...
[47]
Focal Therapy Not Inferior to Radical Prostatectomy for Prostate ...
Apr 9, 2024 · In a clinical trial, the risk of requiring salvage therapy was lower with HIFU compared with radical prostatectomy. Focal therapy via ...Missing: equivalence | Show results with:equivalence
[48]
Holmium Laser Enucleation of the Prostate (HoLEP) - Tebcan
Find top Holmium Laser Enucleation of the Prostate (HoLEP) Doctors in Jordan and book appointments online instantly! View details of doctor's education and ...Missing: East | Show results with:East
[49]
A Randomized Clinical Trial | Journal of Urology
Jul 1, 2024 · We report herein the first RCT comparing RRP vs RALP achieving similar postoperative complications in 90 days and better functional outcomes ...
[50]
Comparison of transfusion requirements between open and robotic ...
Although both groups had low transfusion rates, the RALP group required fewer transfusions than the RRP group (0.8% vs 3.4%, P= 0.002). On univariate analysis, ...
[51]
Incidence of Rectal Injury After Radical Prostatectomy - NIH
May 4, 2023 · Rectal injury is a rare, but potentially devastating, complication following radical prostatectomy. Its incidence is higher in patients ≥60 yr of age.
[52]
A Comprehensive Overview of Intraoperative Complications during Retzius-Sparing Robot-Assisted Radical Prostatectomy: Single Series from High-Volume Center
### Summary of Intraoperative Complications in Retzius-Sparing Robot-Assisted Radical Prostatectomy
[53]
Urinary tract infection after radiation therapy or radical prostatectomy ...
May 3, 2023 · In a prospective study involving approximately 425 robot-assisted RP-treated patients, the UTI incidence rate was 6.1% 30 days after surgery [17] ...Missing: wound | Show results with:wound
[54]
Postoperative wound dealing and superficial surgical site infection ...
Recent studies have revealed that radical retropubic prostatectomy (RRP) had a 2·2–6·4% SSI ratio after the publication of the CDC guideline 17, 18 and this ...
[55]
The PREVENTER Randomized Clinical Trial - PubMed
May 19, 2020 · We found that pharmacologic prophylaxis did not reduce postoperative symptomatic venous thromboembolism significantly for men at routine risk.
[56]
Low Risk of Venous Thromboembolism After Robot-assisted Radical ...
(a) The rates of VTE, DVT and PE after RARP were 5.7% (12/209), 2.9% (6/209) and 3.8% (8/209), respectively. (b) The rates of VTE, DVT and PE after TUR-BT ...
[57]
pd53-02 incidence, risk factors, and impact of cardiovascular events ...
Perioperative CV events are relatively rare (2%) following radical prostatectomy. Several factors including increased BMI, elevated serum creatinine, and low ...
[58]
Perioperative Complications and In-Hospital Mortality After Radical ...
Jul 16, 2025 · Perioperative complications, estimated hospital cost, length of stay, and mortality rates after radical prostatectomy in prostate cancer ...
[59]
Systematic review on urinary continence rates after robot-assisted ...
Jan 10, 2024 · The objective was to investigate the current evidence and discern urinary continence rates post robot-assisted laparoscopic radical prostatectomy (RALP).
[60]
Comparison of Robot-Assisted Radical Prostatectomy and Open ...
Meanwhile, several physician-reported studies showed incontinence rates ranging from 10 to 15% at 12 months after radical prostatectomy.32,33 Considering that ...
[61]
Erectile Dysfunction after Radical Prostatectomy - NIH
Mar 1, 2017 · While there is a large discrepancy in prevalence rates of ED after RP, several recent studies have cited rates as high as 85%. The concept of “ ...
[62]
Fertility After Prostate Cancer Treatment | Johns Hopkins Medicine
The best chance for fertility is sperm banking. Semen containing sperm is frozen in liquid nitrogen. After thawing, up to 50% of sperm will regenerate.<|separator|>
[63]
Management of bladder neck stenosis and urethral stricture and ...
Based on this data, the overall incidence of urethral stricture and stenosis treatment following prostate cancer therapy is 5.2% (3). True incidence of urethral ...Introduction · Nomenclature · Background · Management
[64]
Management of Bladder Neck Contracture in the Age of Robotic ...
The incidence of BNC has been reported as 2.6–7.5% after open retropubic prostatectomy (ORP) versus 0–2.1% after robot-assisted laparoscopic prostatectomy (RALP) ...
[65]
Improvement of Continence Rate with Pelvic Floor Muscle Training ...
Nov 22, 2014 · This meta-analysis aimed to assess the improvement in urinary continence rate by strengthening the pelvic floor muscles after radical ...
[66]
Post-prostatectomy incontinence: Etiology, evaluation, and ...
In a randomized controlled trial by Van Kampen et al., 88% of men who performed pelvic floor exercises were completely continent at 3 months following ...<|control11|><|separator|>
[67]
Male Slings for Post-prostatectomy Incontinence - PMC
Overall success rate was 76.9% and 76.8% at 12 and 36 months, respectively. Complications were reported by most patients, but were nearly all mild and transient ...
[68]
Post-prostatectomy incontinence and the artificial urinary sphincter
A total of 90% of the patients reported satisfaction with the artificial urinary sphincter and 96% stated that they would recommend or had recommended the ...
[69]
The artificial urinary sphincter and male sling for postprostatectomy ...
Success rates from prospective series range from 54% to 80%, with cure rates generally around 50% [36,37,38]. Transient urinary retention has been reported in 3 ...
[70]
Management of erectile dysfunction following radical prostatectomy
... response rates of 50% to 70%. Unfortunately, long-term compliance is suboptimal, with a discontinuation rate of nearly 50% at one year. These non-oral ...<|control11|><|separator|>
[71]
Postprostatectomy Erectile Dysfunction: The Role of Penile ... - NIH
The likelihood of response to PDE5-Is increases with time, and has been shown to be ineffective in the first 6 to 9 months after RP in some series. Treatment ...
[72]
Low-Intensity Extracorporeal Shock Wave Therapy (LI-ESWT) for ...
Oct 5, 2025 · LI-ESWT appears to be a safe and potentially effective treatment for ED following radical prostatectomy, particularly when initiated early and ...
[73]
Urethral Strictures - StatPearls - NCBI Bookshelf
Bladder neck strictures can be treated with dilation, bladder neck incision, or transurethral resection of the contracture. For intractable or recurrent lesions ...
[74]
[PDF] Nerve Graft to Restore Erectile Function During Radical ...
Oct 1, 2025 · Autologous (e.g., sural) or allogenic nerve grafts to restore erectile function during or after radical prostatectomy are unproven and not ...
[75]
Incontinence after Prostate Treatment: AUA/GURS/SUFU Guideline
This guideline on incontinence after prostate treatment (IPT) is intended to facilitate care decisions and aid clinicians in the management of patients.
[76]
Which Prostatectomy is Best for You? - Brown University Health
... prostatectomy spend an average of 1.3 days in the hospital. The reported length of stay for open surgery is 3.16 days. Recovery after surgery also differs ...
[77]
Robotic Prostatectomy FAQs | UC Davis Department of Urologic ...
A traditional, open radical prostatectomy requires two days hospitalization and recovery lasting about 2 months. With robotic-assisted surgery, the recovery ...
[78]
Radical prostatectomy - discharge: MedlinePlus Medical Encyclopedia
Apr 1, 2025 · This article tells you how to take care of yourself at home after the surgery. When You're in the Hospital. Expand Section. You had surgery to ...
[79]
[PDF] Instructions for Care after a Radical Prostatectomy (Prostate Surgery)
This document will assist you as you recover from prostate surgery. The healing process takes time. Follow these instructions while you are in the hospital and ...
[80]
After Robotic Prostate Surgery | Mount Sinai - New York
You can start daily activities (such as walking and climbing stairs) immediately when you get home. However, you should wait three to four weeks before ...
[81]
[PDF] Robotic Prostatectomy - After Surgery
► Always keep your drainage bag lower than your bladder. ► Your catheter will be removed 5 to 7 days after your surgery. ► After your catheter is removed you ...Missing: management postoperative<|separator|>
[82]
Pain Control after Radical Prostatectomy | Johns Hopkins Medicine
Nov 3, 2018 · Radical prostatectomy patients needed less than a quarter of the pain medications they were prescribed.
[83]
Pain Management After Robotic Urologic Surgery
NSAIDs and acetaminophen are frequently used together. Although they have different mechanisms of reducing inflammation, they work very well to assist with pain ...
[84]
PROSPECT guidelines update for evidence-based pain ... - PubMed
Basic analgesia for prostatic surgery should include paracetamol and NSAIDs or COX-2 selective inhibitors. TAP block should be recommended as the first-choice ...
[85]
[PDF] EAU GUIDELINES ON THROMBOPROPHYLAXIS IN UROLOGICAL ...
For patients undergoing open radical prostatectomy without PLND or with standard PLND, for those at low risk of VTE, the use of pharmacological prophylaxis is ...
[86]
EAU Guidelines on Prostate Cancer - Follow-up
1. Prostate-specific antigen monitoring after radical prostatectomy. Following RP, the PSA level is expected to be undetectable. Biochemical recurrence is any ...
[87]
How Kegels Can Help After Prostate Surgery
May 31, 2023 · Men can do Kegel exercises to help strengthen their pelvic floor muscles, stop urinary incontinence and help with erectile dysfunction.
[88]
Diet and prostate cancer
Try to be active and stay a healthy weight, and avoid constipation as this puts pressure on the pelvic floor muscles and bladder, making urinary problems worse.
[89]
After a Radical Prostatectomy: What to Expect
May 11, 2020 · Men can resume sex and activities such as walking or swimming immediately. More strenuous exercise should wait at least six weeks.
[90]
Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline
This guideline on salvage therapy for recurrent prostate cancer is intended to facilitate care decisions and aid clinicians in caring for patients who have ...
[91]
Five-year biochemical recurrence-free and overall survival following ...
The aim was to describe risk factors for biochemical recurrence (BCR) and death, as well as BCR rates and overall survival (OS) rates in both treatment groups.
[92]
Clinical Outcomes of Patients with Localized and Locally Advanced ...
The 5-year and 8-year overall survival (OS) was 97.5% and 93.1%, respectively (Figure 1A). The 5-year and 8-year bRFS rates were 95.3% and 89.6%, respectively.
[93]
Population-based 10-year event-free survival after radical ...
PCSS for all 1360 prostatectomy patients was 98% at 10 years, with an overall survival of 87% (Fig. 4).
[94]
10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for ...
Sep 14, 2016 · At a median of 10 years, prostate-cancer–specific mortality was low irrespective of the treatment assigned, with no significant difference among treatments.
[95]
Journal of Urology - LWW
Although 12-month continence rates range from 85-95% in established studies, few patients are continent in the early postoperative period. The posterior ...
[96]
Nerve-sparing robot-assisted radical prostatectomy - NIH
Using as validated 36 item health survey questionnaire, they reported potency rates of 47%, 54%, 66% and 69% at 1, 3, 6 and 12 months respectively with or ...
[97]
POTENCY, CONTINENCE AND COMPLICATIONS IN 3,477 ...
Nerve sparing RRP can be performed with favorable potency and urinary continence. Better results are achieved in younger men. Other complications are reduced.Return Of Erections After... · Return Of Urinary Continence · Other Postoperative...
[98]
Expanded Prostate Cancer Index Composite (EPIC)
Minimally Important Differences for EPIC-26 ; Urinary incontinence, 6-9 ; Urinary irritative/obstructive, 5-7 ; Bowel, 4-6 ; Sexual, 10-12 ; Vitality/hormonal, 4-6 ...
[99]
Patient-Reported Outcomes after Monitoring, Surgery, or ...
Sep 14, 2016 · The negative effect of prostatectomy on urinary continence and sexual function, particularly erectile function, was greatest at 6 months, and ...<|separator|>
[100]
Functional Outcomes After Localized Prostate Cancer Treatment
Higher EPIC-26 domain scores (range, 0-100) indicate better function. Minimum clinically important differences (MCIDs) were as follows: sexual function, 10 to ...
[101]
Predicting long term outcomes following radical prostatectomy using ...
Feb 18, 2025 · Recurrence-free and metastasis-free survival were 74% and 96% at 10 years, respectively. Median (IQR) MMAI risk scores were 0.25 (0.18-0.33). On ...
[102]
ASCO 2025: External Validation of a Pathology-Based Multimodal ...
Jun 3, 2025 · The current validation study assesses the performance of the post-RP MMAI model in a real-world institutional cohort of prostatectomy patients, ...
[103]
Artificial intelligence model for predicting early biochemical ... - Nature
Aug 21, 2025 · Artificial intelligence model for predicting early biochemical recurrence of prostate cancer after robotic-assisted radical prostatectomy.
[104]
September 2023 - Mortality rates for many types of cancer ... - RNFA
Healthcare providers perform about 90,000 prostatectomies each year in the United States. Prostate cancer is the second most common cancer that affects men ...
[105]
United States (US) Prostatectomy Procedures Count by Segments ...
Apr 28, 2023 · US Prostatectomy Procedures Market Report Overview. The total number of Prostatectomy Procedures performed in the US was 82,728 in 2022.
[106]
Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy ...
Mar 11, 2023 · ... prostatectomy (553 men), or radiotherapy (545 men). The median age at diagnosis was 62 years (range, 50 to 69), and the median PSA level was ...
[107]
Key Statistics for Prostate Cancer
How common is prostate cancer? The American Cancer Society's estimates for prostate cancer in the United States for 2025 are: About 313,780 new cases of ...
[108]
Time Trends in Use of Radical Prostatectomy by Tumor Risk and ...
Jun 3, 2021 · Among those treated with RP, men with PCCI scores of 0 to 2, 3 to 6, 7 to 9, and 10 or higher have 10-year overall mortality rates of 7% to 15%, ...
[109]
Prostate cancer statistics, 2025 - Kratzer - Wiley Online Library
Sep 2, 2025 · ... United States will develop prostate cancer, with an estimated 313,780 new cases of prostate cancer in the United States in 2025. The risk of ...Abstract · INTRODUCTION · MATERIALS AND METHODS · SELECTED FINDINGS
[110]
Radical prostatectomy: lower rates among African-American men - NIH
During the period under study, prostate cancer among Medicare patients in New York rose by 33.8% for African Americans and 26.5% for whites. Significantly, ...Missing: disparities | Show results with:disparities
[111]
The Impact of Surgeon Experience and Volume on Patient ...
This study included eight surgeons who conducted 1,822 radical prostatectomies over a one-year period (1,392 before and 430 after intervention). Individual ...
[112]
New ACS Prostate Cancer Statistics Report: Late-Stage Incidence ...
Sep 2, 2025 · Prostate cancer is the most common cancer diagnosis among men in the U.S., accounting for 30% of male cancers in 2025, and is the second ...
[113]
[PDF] The enlarged prostate: a brief history of its surgical treatment
Goodfellow of Tombstone, Arizona, later performed the first planned and complete removal of the adenoma when he enucleated both lateral and median lobes of an ...
[114]
Prostatectomy Mortality: A Changing Picture - jstor
The mortality of prostatectomy has fallen in recent years. Early in this century a figure of about 20% was published from large hospitals (Groves, 1908; Dobson,.
[115]
https://www.jstor.org/stable/20356362
[116]
History of the prostate, part three: 'the size of a filbert!', open surgery
Sep 23, 2021 · McGill also credited Belfield with the first purposeful open prostatectomy carried out in October 1886.
[117]
[PDF] Open Prostatectomy
Eugene Fuller (1858-1930) of New York published a clear method of transvesical complete enucleation of the benign prostate in 1895 but I think it is reasonable ...
[118]
The discovery of the cavernous nerves and development ... - PubMed
Twenty-five years ago, on April 26, 1982, the first purposeful nerve sparing radical prostatectomy was performed. One year following surgery patient sexual ...
[119]
40th Anniversary of a Lifesaving Discovery | Johns Hopkins Medicine
Nov 2, 2020 · On April 26, 1982, Walsh performed the first purposeful nerve-sparing operation. This man recovered his potency quickly, and he remains cancer-free today.
[120]
Robotic Surgery: Applications - PMC - NIH
The first da Vinci surgical system came out in 1999 and was FDA approved in 2000. In 2003, a fourth robotic arm was added. The da Vinci S model came out in ...
[121]
History of robotic surgery : From AESOP® and ZEUS® to da Vinci
The first version of the da Vinci® surgical system with three arms became available in Europe in January 1999, and obtained FDA approval in July 2000. It ...
[122]
Current Status of Robotic Surgery - PMC - NIH
The market share of robotic prostatectomy compared to laparoscopic and open prostatectomy is estimated as exceeding 80 % in the USA, according to the ...
[123]
Historic progression of prostatectomy techniques and associated ...
Mar 26, 2025 · By 2013, nearly 85% of all prostatectomies in the United States were performed robotically compared to open techniques (5). In more recent ...
[124]
Changing trends in robot-assisted radical prostatectomy
Luzzago et al studied the time trends for the conversion of minimally invasive radical prostatectomy to open surgery in 57,078 patients undergoing surgery ...
[125]
Latest Advancements and Future Directions in Prostate Cancer ...
Sep 18, 2025 · Results demonstrate a 21% positive SMs rate, a 93% rate of 12-month continence recovery and a 53% 3-month potency recovery rate. Regarding the ...
[126]
The impact of prostate volume on Retzius-sparing robot-assisted ...
Mar 27, 2025 · The continence rate of patients within 1 week was 92%, 90% (using one pad ≤ 1 piece/24 h), and the proportion decreased to 76% when defined as 0 ...
[127]
Artificial Intelligence 3D Augmented Reality–guided Robotic ...
Oct 13, 2025 · Herein, we present the first prospective randomized trial comparing 3D-AR robotic prostatectomy, driven by AI, with the standard cognitive MRI- ...
[128]
Robotic Prostatectomy Cost Breakdown - Bookimed
Oct 16, 2024 · On average, the cost of robotic prostatectomy ranges from $14,000 to $40,000 or more. Traditional radical prostatectomy typically costs between ...
[129]
https://miamiroboticprostatectomy.com/prostatectomy-surgery-recovery-time-cost/
[130]
Prostate Gland Removal (Prostatectomy) Cost in Texas - MDsave
On MDsave, the cost of a Prostate Gland Removal (Prostatectomy) ranges from $12,295 to $12,503. Those on high deductible health plans or without insurance can ...What Is Mdsave, And Who Can... · Frequently Asked Questions · Patients Love MdsaveMissing: self- | Show results with:self-
[131]
How Much Does a Prostatectomy - Robotic Cost Near Me? - MDsave
On MDsave, the cost of a Prostatectomy - Robotic ranges from $16,046 to $25,906. Those on high deductible health plans or without insurance can shop, compare ...Missing: self- | Show results with:self-
[132]
Medicare Coverage for Prostate Surgery - Healthline
Aug 23, 2024 · The table below provides the national average costs for prostate procedures based on Medicare's 2024 payments and copayments. Costs include ...
[133]
Regional Cost Variations of Robot-Assisted Radical Prostatectomy ...
Studies have shown RARP to be from $200 to $2000 more expensive than ORP. Many factors contribute to the high overall cost of RARP including the initial capital ...
[134]
Variation in prostate surgery costs and outcomes in the USA: robot ...
Jan 8, 2019 · For patients with at least three comorbidities, the mean cost in RARP ($19,554; 95% CI: $19,206–$19,909) was significantly greater by $2190 (95% ...
[135]
National estimated costs of never events following radical ...
While surgical events occurred most frequently, medical complications generated $1,699 (95% CI 994–2,423), $2,052 (95% CI 1,545–2,662) and $4,852 (95% CI 3,519 ...
[136]
The Cost Burden of Complications after Major Surgery for Urological ...
Mar 1, 2016 · While surgical events occurred most frequently, medical complications generated $1,699 (95% CI 994–2,423), $2,052 (95% CI 1,545–2,662) and ...
[137]
Economic Burden of Illness Associated with Localized Prostate ...
The cumulative cost of managing localized prostate cancer on a per-patient basis was estimated to be $46,193 over 5 years and $110,993 over 10 years. For a ...
[138]
7.590 € Holmium laser Prostate Surgery (HoLEP) in Spain
As you've seen, the cost of a private prostate surgery with holmium laser in Spain with Operarme is 7.590 €: a closed price with all the services included.
[139]
Holmium Laser Enucleation of the Prostate in Spain - Bookimed
Mar 13, 2025 · Holmium Laser Enucleation of the Prostate (HoLEP) in Spain typically costs from $4,500 to $8,000. Pricing can vary depending on the hospital ...
[140]
Cancer treatment in Europe vs USA - Universal Medical Travel
Jan 14, 2025 · Treatment costs are largely covered by government funding or mandatory health insurance schemes, minimizing out-of-pocket expenses for patients.Missing: prostatectomy | Show results with:prostatectomy
[141]
Best Hospitals for HoLEP (Holmium Laser Enucleation of the prostate)
Average HoLEP (Holmium Laser Enucleation of the prostate) Cost ; India · $3000 ; UAE · $6800 ; Egypt · $9000 ...Missing: Asia | Show results with:Asia
[142]
Abstracts - 2024 - BJU International - Wiley Online Library
Feb 20, 2024 · Multi-centre audit of holmium laser enucleation of the prostate (HoLEP) – initial experience in Brisbane ... Southern Asia and the Middle East, 8 ...
[143]
HoLEP (Holmium Laser Enucleation of the prostate) Cost in Dubai
Cost-effective HoLEP (Holmium Laser Enucleation of the prostate) in Dubai with world-class care. Get FREE Quotes, Expert Guidance, and a Second Opinion from ...
[144]
The Availability, Cost, Limitations, Learning Curve and Future of ...
Mar 15, 2023 · This comprehensive narrative review aims to explore the merits of each robotic system as well as the evidence and barriers to their use.
[145]
Current Feasibility of Urologic Telesurgery in Low/Middle Income ...
Approximately 94% of individuals in low- and middle-income countries (LMICs) lack access to surgery in comparison to 14.9% in high-income countries (HICs).
[146]
Addition of a surgery-specific module to a perioperative ...
Oct 7, 2025 · We aimed to assess the impact of adding a surgery-specific module to an optimized digital perioperative program on improving functional outcomes ...
[147]
Economic Evaluation of Robotic-assisted Radical Prostatectomy
Feb 8, 2025 · RARP is generally cost effective compared with LRP, although not statistically significant, and shows no significant cost effectiveness advantage over ORP.
[148]
How do healthcare prices and utilization in the United States ...
Sep 4, 2025 · Prostatectomies per 100,000 men, 2021, Public insurance: cost per prostatectomy, 2022, Private plans: cost per prostatectomy, 2022. Belgium. 97.Missing: universal | Show results with:universal