This prospective randomized study aimed to assess the effect of self-selected music, delivered via loudspeaker, on early postoperative anxiety and pain in patients who underwent anatomical endoscopic enucleation of the prostate (AEEP) under spinal anesthesia without sedation. Adult male patients scheduled for AEEP were randomly allocated to either a music intervention group (self-preferred music) or a control group (no music). Baseline characteristics, preoperative urethral catheter status, International Prostate Symptom Scores (IPSS), operative duration, and pre- and postoperative anxiety scores (State Anxiety Inventory, SAI) were recorded. Visual Analog Scale (VAS) was used to evaluate postoperative pain two hours after surgery. A total of 135 patients were analyzed (music group, n= 67; control group, n= 68). Baseline characteristics and operative times were comparable between groups (p>0.05). The music group had significantly lower postoperative SAI (32.0 ± 7.32 vs. 38.38 ± 11.28; p = 0.001) and VAS scores (1 [1-2] vs. 2 [1-3]; p = 0.001). The reduction in postoperative SAI compared to preoperative value was also greater in the music group (14 [10.00-21.00] vs. 7 [1.00-11.75]; p = 0.001). Music type had no significant impact on outcomes (p>0.05). In multivariate analysis, music intervention and preoperative catheterization were independent predictors of postoperative anxiety. Self-selected music intervention significantly reduced early postoperative anxiety and pain following AEEP under spinal anesthesia. Given its simplicity and non-invasive nature, music may serve as an effective adjunct for enhancing patient comfort, regardless of music genre. NCT07255118.

Background/Objectives: We aimed to evaluate the feasibility and safety of a combined approach to partial nephrectomy, which involves laparoscopic dissection for kidney as well as renal hilum mobilization, followed by robotic assistance for tumor resection and intracorporeal suturing, integrating the technical advantages of both laparoscopic and robotic surgery. Methods: We retrospectively analyzed 99 patients with clinical stage 1 renal tumors who underwent laparoscopic (LPN, n = 31), robot-assisted (RAPN, n = 16), or combined partial nephrectomy (CPN, n = 52) between 2016 and 2024. CPN involved laparoscopic mobilization of the kidney and renal hilum, followed by robotic tumor excision and intracorporeal suturing. Perioperative and postoperative outcomes were compared across groups. Results: Comparative analysis of the demographic characteristics of patients who underwent LPN, RAPN and CPN revealed no significant differences. The mean operative time (OT) was 126.75 ± 25.28 min for CPN, 121.9 ± 9.5 min for LPN (p = 0.014), and 155.5 ± 18.03 min for RAPN (p < 0.001). The median warm ischemia time (WIT) was 20.0 min (10.0–26.0) for CPN, which is comparable to RAPN at 18.5 min (14.0–23.0) (p = 0.158), but it was significantly longer for LPN at 23.0 min (18.0–28.0) (p < 0.001). The estimated blood loss (EBL) was 120.0 mL (50.0–350.0) for CPN, which is similar to RAPN at 110.0 mL (50.0–300.0) (p = 0.158), while it was higher for LPN at 180.0 mL (100.0–250.0) (p < 0.001). No major intraoperative or postoperative complications classified as Clavien–Dindo grade ≥3 were observed in any group. Conclusions: CPN is a feasible and safe approach for clinical stage 1 renal tumors, combining the efficiency of laparoscopy with the precision of robotics. Compared with LPN and RAPN, CPN showed comparable early oncological and functional results and had shorter operative duration and improved perioperative parameters.