Introduction: There are numerous options available for the surgical treatment of benign prostate hyperplasia, and single-port robotic-assisted simple prostatectomy (SP-RASP) has emerged as a novel method in this field. In this study, we aim to define the trifecta of same-day discharge (SDD) and identify the factors associated with the trifecta of SDD following SP-RASP. Materials and Methods: Data from 95 patients who underwent SP-RASP between February 2020 and July 2024 at a single center by a single surgeon were evaluated. The trifecta of SDD was defined as a patient being discharged on the same day without experiencing any 90-day postoperative complications and no readmissions. The factors associated with predicting the trifecta of SDD were investigated. Results: A total of 95 SP-RASP cases were successfully performed without the need for conversion to alternative approaches, and 54 patients (56.8%) were included in the trifecta of the SDD-achieved group. The reasons for failure included 23 patients (24.2%) requiring postoperative hospitalization from the recovery area, 24 patients (25.3%) experiencing postoperative complications, and 2 patients (2.1%) needing readmission within 90 days after discharge. There was a 0% incidence of major postoperative complications (≥Clavien–Dindo grade 3). When comparing the groups, trifecta-achieved patients showed lower estimated blood loss, smaller specimen weight, lower percentage of adenoma removed, and a reduced rate of opioid prescriptions at discharge ( p = 0.005, 0.033, 0.025, and 0.026, respectively). In the multivariate logistic regression analysis, specimen weight was the only factor significantly associated with trifecta following SP-RASP ( p = 0.018). Conclusion: In our cohort, 56% of patients were classified within the trifecta group, with no major postoperative complications observed following SP-RASP. Specimen weight was the only independent predictor of trifecta achievement in these patients.

Background: The Da Vinci single-port (SP) platform is being used more frequently in radical prostatectomy (RP). In this study we aimed to compare the complications and oncological outcomes of the Da Vinci SP platform in robotic-assisted radical prostatectomy (SP-RARP) between elderly and young age-groups and to further examine differences between young-old and old-old patients. Materials and Methods: Data from 193 patients who underwent SP-RARP between December 2018 and June 2024 were analyzed. Patients were categorized into two age-groups: young (18-64 years) and elderly (65+ years). The elderly group was further divided into young-old (65-69 years) and old-old (70+ years) subgroups. The analysis considered variables related to patient characteristics, intraoperative outcomes, complications, and postoperative oncological outcomes. Results: The median age of the patients at the time of surgery was 64 (9.5) years. The intraoperative complication rate of 1.6%, with no cases requiring conversion to open surgery. The overall incidence of postoperative adverse events was 24.4%, and the 30-day readmission rate was 11.4%. Intraoperative complications and 30-day readmission rates were similar between groups (P = .593 and P = .821, respectively), while the postoperative complication rate was significantly higher in the younger patient group (P = .012). The median length of hospital stay (LOS) was 7 (22) hours and 110 (57%) patients were discharged on the same day (SDD). LOS and SDD rates were similar between groups (P = .389 and P = .529, respectively). The 3-year and 5-year biochemical recurrence (BCR)-free survival rates were 80.5% and 75.1%, respectively. The BCR-free survival rates were similar between both young and elderly patients and between the young-old and old-old groups (P = .751, P = .765, respectively). Conclusion: SP-RARP is a feasible option for elderly patients, delivering acceptable oncological outcomes with a low incidence of postoperative complications.

Article: Contemporary methods for surgical margin assessment in radical prostatectomy: a systematic review and meta-analysis of diagnostic test accuracy - Minerva Urology and Nephrology 2026 February;78(1):26-39 - Minerva Medica - Journals

Background/Objectives: An 80-year-old man was admitted to our department after a salvage radical cystectomy for actinic cystitis due to radiotherapy for prostate cancer. He presented with a two-month history of feculent debris in the right stoma and deteriorated general conditions, after a long past medical history of recurrent complicated urinary infections. Methods: Computer tomography (CT) of the abdomen revealed a ureterocolic fistula along the right ureteral pelvic tract. A right percutaneous nephrostomy tube was placed. Due to multiple previous surgeries, several lines of intravenous antibiotic therapies and the overall condition of the patient, a conservative management was preferred. Results: A bovine serum albumin-glutaraldehyde (BioGlue^®) adhesive was inoculated into the right ureter through the stoma to close the fistula. After 24 months, the patient remained asymptomatic with negative follow-up imaging. Conclusions: Given the uniqueness of the management of a ureterocolic fistula, this case offers insight into conservative treatment in frail patients not suitable for major surgery.