{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:56:04Z","timestamp":1790722564768,"version":"4.1.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Prostate Cancer Prostatic Dis"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Single-Port Transvesical Enucleation of the Prostate (STEP) is a minimally invasive robotic technique for managing benign prostatic hyperplasia (BPH), particularly in prostates \u2267\u00a080 cc. However, its outcomes in very large prostates (&gt;150 cc) remain under-characterized. We compared perioperative and functional outcomes of STEP between large (LP: 80\u2013150 cc) and very large prostates (VLP: &gt;150 cc).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 183 patients who underwent STEP using the da Vinci Single-Port system (2019\u20132024). Patients were stratified into LP and VLP cohorts based on prostate volume (PV). Enucleation efficiency was defined as enucleated tissue weight divided by enucleation time (g\/min). Outcomes were compared using descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 179 patients were included (LP: 93; VLP: 86). Median PV was significantly greater in the VLP group (194 vs. 117 cc,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). VLP patients had higher PSA (9.7 vs. 6.75\u2009ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), longer enucleation (84 vs. 69\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and console times (115 vs. 98\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), and improved enucleation efficiency (1.23 vs. 0.97\u2009g\/min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025). Estimated blood loss was slightly higher in VLP (100 vs. 80\u2009mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026). All procedures were completed without conversion or additional ports. Hospital stay, catheter duration, and same-day discharge rates were comparable. At 3 months, both groups had equivalent improvements in International Prostate Symptom Score (3 vs. 3,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.913), quality-of-life scores (0 vs. 1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.965), and maximum flow rate (17.5 vs. 16\u2009mL\/s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.594). Complications were rare, with no readmissions and only two major postoperative events. Urinary continence was preserved in all patients, with transient incontinence occurring in 6 patients (LP: 2; VLP: 4), resolving completely by 3 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>STEP is effective and scalable for prostates \u2265\u00a080 cc, demonstrating improved enucleation efficiency in very large glands without compromising safety, recovery, or continence preservation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41391-026-01074-y","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T20:53:37Z","timestamp":1771707217000},"page":"791-798","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single-port transvesical enucleation of the prostate (STEP) for benign prostatic hyperplasia: a comparative analysis of patients with large (80\u2013150cc) and very large (&gt;150cc) prostate volumes"],"prefix":"10.1038","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6596-9100","authenticated-orcid":false,"given":"Salim K.","family":"Younis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas A.","family":"Soputro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M.","family":"Pedraza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carter D.","family":"Mikesell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Al-Bayati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samarpit","family":"Rai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui M.","family":"Bernardino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4895-7106","authenticated-orcid":false,"given":"Ruben","family":"Olivares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Eltemamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyad R.","family":"Schwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Autorino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7127-6069","authenticated-orcid":false,"given":"Jihad","family":"Kaouk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"1074_CR1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/JU.0000000000003698","volume":"211","author":"JS Sandhu","year":"2024","unstructured":"Sandhu JS, Bixler BR, Dahm P, Goueli R, Kirkby E, Stoffel JT, et al. 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ZRS serves as a proctor and consultant for Intuitive Surgical.\u00a0The remaining authors have no disclosures.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This study was approved by the Cleveland Clinic Institutional Review Board (IRB) and conducted in accordance with the Declaration of Helsinki. The need for informed consent was waived by the IRB due to the retrospective nature of the study (IRB protocol number: 14-265).","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Ethics"}}]}}