Application of robotics in the treatment of benign prostatic hyperplasia: a narrative review

Abstract

A range of surgical approaches are available for treating benign prostatic hyperplasia (BPH), with emphasis placed not only on their effectiveness but also on minimizing invasiveness. The advent of surgical robotics has revolutionized BPH treatment, with robot-assisted simple prostatectomy offering a less invasive alternative to traditional approaches. The emergence of single-port systems has also earned attention for being effective in confined spaces. Aquablation represents a distinct robotic platform utilizing a heat-free, high-velocity waterjet to ablate prostate adenomas according to pre-registered configurations under real-time imaging. These novel technologies have proven to treat large prostates exceeding 80 mL efficiently and safely. Furthermore, Aquablation, along with technical modifications such as urethra-sparing robot-assisted simple prostatectomy, have demonstrated effectiveness in preserving ejaculatory function, thereby enhancing patients' overall quality of life. As evidence accumulates and technology and techniques evolve, robotic interventions for BPH may serve as a new standard in the field in the future.