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Evolution of Benign Prostatic Hyperplasia Treatment: Advantages of Robotic Surgery

13/02/2026
in News, Urological Hub
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Benign prostatic hyperplasia (BPH), commonly known as prostate adenoma, is one of the most prevalent urological conditions in men. It represents a pathological enlargement of the prostate gland, primarily driven by hormonal imbalance—particularly the altered ratio between androgens and estrogens. Over time, the enlarged gland compresses the urethra, leading to significant impairment of urinary function.

Pathophysiology and Clinical Manifestations

When the enlarged prostate exerts mechanical pressure on the urethra, the urinary bladder must overcome increased resistance to achieve complete emptying. This chronic overload leads to hypertrophy of the bladder wall musculature, which gradually diminishes its functional capacity.

Timely diagnosis is critically important to prevent serious urological complications, including:

  • Chronic urinary tract infections

  • Bladder stone formation

  • Renal dysfunction and kidney damage

The main symptoms of BPH include:

  • Difficulty initiating urination or intermittent voiding

  • Weak urinary stream

  • Sensation of incomplete bladder emptying

  • Increased urinary frequency, especially at night (nicturia)

  • Pain or discomfort during urination

Diagnostic Evaluation of Prostate Adenoma

Diagnostic assessment includes:

  • 29 MHz Prostate Micro-Ultrasound – an innovative imaging modality that provides a 300% higher-resolution image compared to conventional ultrasound. Clinical data indicate that micro-ultrasound demonstrates diagnostic accuracy in detecting prostate cancer comparable to, and in some cases exceeding, magnetic resonance imaging (MRI).
    The Karazanashvili Robotic Center is a technological leader in the region, being the first to introduce this advanced diagnostic method and currently maintaining exclusive status as the only center in the Caucasus and Black Sea region where this examination is available.

  • Prostate-Specific Antigen (PSA) blood test

  • Serum creatinine

  • Urinalysis

  • Uroflowmetry – assessment of urinary flow rate

  • Urethrocystography – contrast-enhanced radiographic examination of the bladder

Overview of Surgical Treatment Methods

The surgical management of prostate adenoma has evolved significantly over the years. The principal methods include:

1. Open Adenomectomy

This traditional surgical approach is highly invasive and associated with significant blood loss, prolonged postoperative recovery, and extended hospitalization.

2. Holmium Laser Enucleation of the Prostate (HoLEP)

Introduced in the late 20th century, Holmium Laser Enucleation of the Prostate represented a less invasive alternative. Despite its initial popularity, clinical practice has revealed certain complications, including postoperative fever, thermal tissue damage, and urethral stricture formation. Over time, advancements in technology—particularly robotic surgery—have provided superior precision and improved functional outcomes.

3. Robotic Adenomectomy: The Contemporary Gold Standard

Robotic surgery represents the most advanced and effective treatment modality for BPH. The Karazanashvili Robotic Center has been offering this method for years, with clear and well-documented advantages:

  • Minimally invasive approach – performed through small incisions, reducing tissue trauma.

  • Minimal blood loss – enhanced visualization and precision significantly lower bleeding risk.

  • Reduced postoperative complications – decreased rates of infection and postoperative pain.

  • Rapid recovery – short hospitalization and faster return to normal daily activities.

These advantages enable patients to make informed decisions and select the safest and most effective treatment pathway.

Conclusion

The Karazanashvili Robotic Center, with its extensive clinical experience, is a leading institution in the Caucasus and Black Sea region. The center successfully performs urological, gynecological, oncological, and abdominal procedures using robotic surgery, offering patients medical care that meets international standards of excellence.

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