Introduction: Single-port (SP) robot-assisted simple prostatectomy (RASP) is a novel approach for patients with obstructive benign prostatic hyperplasia. Our aim is to report updated data comparing SP vs multi-port (MP) robotic systems. Methods: We analyzed all consecutive RASP cases done in 5 centers in the US from January 2017 to October 2022. Measures of central tendency were compared with t-test or Mann-Whitney U test depending on their distribution. Frequencies were compared with Chi-square. Statistical significance was considered when p=0.05. Results: A total of 405 cases were analyzed, 249 MP and 156 SP. The SP group patients were significantly more symptomatic (p=0.0001). Estimated blood loss during surgery was significantly lower with SP (p=0.00001). Even though the rate of intraoperative complications was higher with SP (3.2% vs 0.4%), the difference was not significant (p=0.06). Postoperatively, SP approach required significantly shorter time of hospital stay, less use and amount of opioids, and shorter time with Foley catheter (all p’s = 0.00001). There was no significant difference between the post-operative Clavien Dindo =3 complication rate (MP 2.4% vs SP 0.6%) Furthermore, the 30-day readmission rate of MP (10.8%) was significantly higher than SP’s (0%) (p=0.00001). Conclusions: The SP robotic approach for simple prostatectomy is advantageous when it comes to postoperative comfort for the patients. Specifically it requires shorter hospital stay, less use and amount of opioids, shorter Foley catheter duration, and less readmission rate. SOURCE OF Funding: None.
