{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:19Z","timestamp":1753893319159,"version":"3.41.2"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Small prostates (volume &amp;lt;30\u2005ml) induce bladder outlet obstruction with pathophysiological changes distinct from those associated with large prostates. Treatment options often include transurethral incision of the prostate (TUIP) or transurethral resection of the prostate (TURP). Existing treatments have issues with high recurrence and complication rates. Therefore, we aim to explore a new minimally invasive surgical approach for patients with severe lower urinary tract symptoms (LUTS) and a small prostate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A patient with severe LUTS and a small prostate was admitted to the Department of Urology at the Second Hospital of Dalian Medical University. The patient had no median lobe but presented with multiple bladder stones. Relevant data (IPSS score, urine flow rate, operation time, hemoglobin drop, catheterization time, hospitalization time, residual urine) were collected before and after surgery to assess the safety and efficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient was 72 years old with a prostate volume of 22.14\u2005ml, a preoperative IPSS score of 28, PSA of 0.314\u2005ng\/ml, maximum urine flow rate of 3.5\u2005ml\/s, and a prostate MRI PI-RADS score of 2. The patient underwent robot-assisted cystolithotomy, urethra-preserving prostatectomy and dorsal capsule fenestration. The surgery lasted 105\u2005min, with a postoperative hemoglobin drop of 3\u2005g\/L. There was no continuous bladder irrigation postoperatively, and the catheter was removed after 10 days. The patient was hospitalized for 4 days and followed up for 24 months. At 6 months postoperative, the patient had an IPSS score of 6, a QoL score of 1, a urine flow rate of 18\u2005ml\/s, and residual urine of 8\u2005ml, with nocturia occurring 1\u20132 times. At 24 months postoperative, the patient had an IPSS score of 7, a QoL score of 1, a urine flow rate of 21\u2005ml\/s, and residual urine of 15\u2005ml, with nocturia occurring 1 time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Robot-assisted urethra-preserving prostatectomy and dorsal capsule fenestration is a promising alternative treatment for patient with severe LUTS due to a small prostate in both long-term safety and efficacy. Further large-sample controlled studies are needed for additional evaluation and validation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2024.1497556","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T06:34:19Z","timestamp":1732775659000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Urethra-preserving and dorsal capsule fenestration with robot-assisted simple prostatectomy for severe LUTS in small prostate: a case report"],"prefix":"10.3389","volume":"11","author":[{"given":"Lijie","family":"Wen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.urology.2015.11.027","article-title":"Urodynamic features and significant predictors of bladder outlet obstruction in patients with lower urinary tract symptoms\/benign prostatic hyperplasia and small prostate volume","volume":"89","author":"Kang","year":"2016","journal-title":"Urology"},{"key":"B2","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.eururo.2023.04.008","article-title":"Summary paper on the 2023 European association of urology guidelines on the management of non-neurogenic male lower urinary tract symptoms","volume":"84","author":"Gravas","year":"2023","journal-title":"Eur Urol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1016\/S0022-5347(17)60172-1","article-title":"Transurethral incision of the prostate","volume":"110","author":"Orandi","year":"1973","journal-title":"J Urol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1002\/nau.10013","article-title":"Comparison of long-term results of transurethral incision of the prostate with transurethral resection of the prostate, in patients with benign prostatic hypertrophy","volume":"21","author":"Tkocz","year":"2002","journal-title":"Neurourol Urodyn"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e4657","DOI":"10.1097\/MD.0000000000004657","article-title":"Effect of transurethral split of the prostate using a double-columnar balloon catheter for benign prostatic hyperplasia: a single-center experience of 565 consecutive patients","volume":"95","author":"Huang","year":"2016","journal-title":"Medicine (United States)"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1016\/S0022-5347(17)39753-7","article-title":"The Madigan prostatectomy","volume":"144","author":"Dixon","year":"1990","journal-title":"J Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1007\/s11934-017-0689-4","article-title":"Extraperitoneal robot-assisted radical prostatectomy: indications, technique and outcomes","volume":"18","author":"Semerjian","year":"2017","journal-title":"Curr Urol Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/S0022-5347(17)49698-4","article-title":"The development of human benign prostatic hyperplasia with age","volume":"132","author":"Berry","year":"1984","journal-title":"J Urol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/S0090-4295(00)01101-8","article-title":"Symptoms and quality of life versus age, prostate volume, and urodynamic parameters in 565 strictly selected men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia","volume":"57","author":"Eckhardt","year":"2001","journal-title":"Urology"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1467","DOI":"10.1016\/j.urology.2009.08.049","article-title":"Correlation between prostatic urethral angle and bladder outlet obstruction index in patients with lower urinary tract symptoms","volume":"75","author":"Ku","year":"2010","journal-title":"Urology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1038\/nrurol.2013.149","article-title":"Prostatic fibrosis, lower urinary tract symptoms, and BPH","volume":"10","author":"Rodriguez-Nieves","year":"2013","journal-title":"Nat Rev Urol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2387","DOI":"10.1056\/NEJMoa030656","article-title":"The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia","volume":"349","author":"McConnell","year":"2003","journal-title":"N Engl J Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1287212","DOI":"10.3389\/fendo.2023.1287212","article-title":"Reoperation after surgical treatment for benign prostatic hyperplasia: a systematic review","volume":"14","author":"He","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B14","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1089\/end.2013.0374","article-title":"Extraperitoneal laparoscopic adenomectomy (Madigan) versus bipolar transurethral resection of the prostate for benign prostatic hyperplasia greater than 80\u2005ml: complications and functional outcomes after 3-year follow-up","volume":"28","author":"Xie","year":"2014","journal-title":"J Endourol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1497556\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T06:34:23Z","timestamp":1732775663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1497556\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":14,"alternative-id":["10.3389\/fsurg.2024.1497556"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2024.1497556","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2024,11,28]]},"article-number":"1497556"}}