Introduction. Endoscopic video surgery is a standard for large-volume benign prostatic hyperplasia (BPH). Various approaches exist: multiport, single-port, and robot-assisted; however, their comparative analysis remains relevant.
Aim: to comprehensively compare intra- and postoperative outcomes, functional results, pain syndrome, and cosmetic effects of single-port, multiport, and robot-assisted adenomectomy.
Materials and methods. A prospective single-center study included 151 patients with BPH (volume >80 cm³), allocated to single-port (n=33), multiport (n=60), and robot-assisted (n=58) adenomectomy groups. Intraoperative parameters, postoperative course, functional outcomes (IPSS, QoL, Qmax, PVR) at 3, 6, and 12 months, pain (VAS, painDETECT), and cosmetic effect (BIQ, CQ) were assessed.
Results. All three methods demonstrated comparable and high efficacy in improving functional parameters (IPSS, Qmax, PVR) at 12 months. The single-port group had a smaller incision length (26 mm, p<0.001), shorter hospitalization (6 days, p=0.002), less pronounced pain, and better cosmetic results (p<0.001). Quality of Life (QoL) was significantly higher in the single-port group. Intraoperative blood loss was higher in the single-port approach (230 ml, p<0.001) but did not affect the complication rate.
Conclusion. Single-port, multiport, and robot-assisted adenomectomy are effective and safe methods for treating BPH. The single-port technique offers advantages of reduced invasiveness, faster recovery, better cosmesis, and improved quality of life, making it a promising patient-centered approach.
