Retzius-sparing robot-assisted radical prostatectomy after previous trans-urethral resection of the prostate: Assessment of functional and oncological outcomes.
Eur J Surg Oncol
; 49(8): 1524-1535, 2023 08.
Article
in En
| MEDLINE
| ID: mdl-37012110
ABSTRACT
BACKGROUND:
no data exist concerning functional and oncological outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP), in patients previously treated with trans-urethral resection of the prostate (p-TURP), for benign prostate obstruction. Our study addressed the impact of p-TURP on immediate and 12-months urinary continence recovery (UCR), as well as peri-operative outcomes and surgical margins, after RS-RARP.METHODS:
all patients treated with RS-RARP for prostate cancer at a single high-volume European institution, between 2010 and 2021, were identified and stratified according to p-TURP status. Logistic, Poisson and Cox regression models were performed.RESULTS:
Of 1386 RS-RARP patients, 99 (7%) had history of p-TURP. Between p-TURP and no-TURP patients no differences were detected regarding both intra- and post-operative complications (p values = 0.9). The rates of immediate UCR were 40 vs 67% in p-TURP vs no-TURP patients (p < 0.001). At 12 months from RS-RARP, the rates of UCR were 68 vs 94% in p-TURP vs no-TURP patients (p < 0.001). At multivariable logistic and Cox regression models, p-TURP was independently associated, respectively, with lower immediate (odds ratio [OR] 0.32, p < 0.001) and 12-months UCR (hazard ratio 0.54, p < 0.001). At multivariable Poisson analyses, p-TURP predicted longer operative time (rate ratio 1.08, p < 0.001) but not longer length of stay or time to catheter removal (p values > 0.05). Positive surgical margins rates were 23 vs 17% in p-TURP vs no-TURP patients (p = 0.1), which translated in a non-statistically significant multivariable OR of 1.14 (p = 0.6).CONCLUSIONS:
p-TURP does not increase surgical morbidity but portends longer operative time and worse urinary continence after RS-RARP.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Prostatic Neoplasms
/
Robotics
/
Robotic Surgical Procedures
Type of study:
Prognostic_studies
Limits:
Humans
/
Male
Language:
En
Year:
2023
Type:
Article