Effect of bony pelvic dimensions measured by preoperative magnetic resonance imaging on performing robot-assisted laparoscopic prostatectomy.

ABSTRACT

OBJECTIVE: To evaluate the effect of bony pelvic dimensions measured by preoperative magnetic resonance imaging (MRI) on performing robot-assisted laparoscopic prostatectomy (RALP). PATIENTS AND METHODS: In this exploratory study, we analysed the data of 141 patients who underwent RALP for clinically localized prostate cancer after undergoing MRI at our institution. Associations of various clinicopathological factors were analysed, including pelvic dimensions measured by preoperative MRI, with operative duration, estimated blood loss (EBL), surgical margin status, and postoperative urinary continence and erectile function. RESULTS: For operative duration, no pelvic dimension had a significant association on univariate analysis, with only the newly developed variable of pelvic cavity index approaching significance (P=0.071). Only prostate volume had a significant association with operative duration on multivariate analysis (P=0.015). For EBL, no bony pelvic dimension had a significant association on univariate analysis, with only intertuberous distance and interspinous distance approaching significance (P=0.087 and P=0.072, respectively). Again, only prostate volume was significantly associated with EBL on univariate analysis (P=0.045). No pelvic dimension had any significant effect on surgical margin status, recovery of urinary continence or erectile function at 6 months after RALP. CONCLUSION: Bony pelvic dimensions may not be a significant factor contributing to the technical difficulty of RALP among Korean patients compared with other patient-related factors such as prostate volume.