Outcomes of robotic modified Freyer's prostatectomy in an Australian patient cohort

Introduction: The study aims to demonstrate the feasibility, safety and efficacy of robotic simple prostatectomy (RSP) using the modified Freyer's approach in an Australian patient cohort. Although RSP is performed in several Australian centres, there is a paucity of published Australian data. Methods: We reviewed prospectively collected perioperative and outcomes data for patients who underwent a robotic modified Freyer's prostatectomy (RMFP) from June 2019 to March 2022. Statistics were completed using SPSS statistics v27.0 and reported as mean and range with a p value of <0.05 considered statistically significant. Results: There were 27 patients who underwent RMFP over the study period with a mean age of 67 years and prostate volume of 159.74 cc (100–275). The mean console time was 168 min (122–211), blood loss of 233 ml (50–600) and average length of hospital stay of 3.8 days (3–8). The preoperative versus postoperative outcome means were as follows: serum prostate-specific antigen was 9.69 versus 1.2 ng/mL, IPPS score was 17.1 versus 1.25, quality of life (QOL) score 3.4 versus 0.4, postvoid residual volume: 223.6 versus 55.9 ml, Q-max 7.86 versus 29.6 ml/s. These were all statistically significant (p < 0.001). The mean weight of resected tissue was 74 g (43–206) with 25 patients having benign histopathology and two being diagnosed with prostate cancer (Gleason 3 + 3 = 6 and 3 + 4 = 7). No patients returned to theatre or required a blood transfusion. Conclusions: Data from our patient cohort demonstrate the feasibility, safety and efficacy of RMFP for benign prostatic hyperplasia in an Australian patient cohort. Our outcomes compare favourably with published studies on RSP.