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Original Research

How Does Previous Transurethral Resection of the Prostate Affect the Results of Robotic Radical Prostatectomy?


1 Sağlık Bilimleri Üniversitesi, Kayseri Şehir Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Kayseri

2 Koç Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul

3 Yıldırım Beyazıt Üniversitesi Tıp Fakültesi, Ankara Atatürk Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara

4 Ankara Atatürk Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, Ankara


DOI : 10.33719/yud.582509
New J Urol. 2019; 14 (2): 91-98

Abstract

Objective: We investigated the impact of transurethral resection of the prostate (TUR-P) on perioperative outcomes in patients who underwent robot assisted radical prostatectomy (RARP).

Material and Methods: A total of 752 cases per- formed by 3 surgeons between February 2009 and December 2017 were reviewed retrospectively. First 100 cases of each surgeon were not included to ex- clude the learning curve effect. All patients (n = 452) were divided into two groups according to having a previous TUR-P history as Group 1 = patients with TUR-P history (n = 38), Group 2 = patients without TUR-P history (n = 414).

Results: Mean patient age was 68.3± 5.9 ver- sus 63.3±6.8 years p=0.00; mean console time was 144.3±37.1 versus 124.6±24.0 minutes, p=0.02; blad- der neck reconstruction was 31.6% versus 16.7%, p=0.02; transurethral catheter removal time was 11.3±5.1 versus 8.6±2.7 days, p=0.00; for groups 1 and 2, respectively. Positive surgical margin rates were 26.3% versus 27.3%, p=0.897; erectile func- tion (IIEF≥17) rates on postoperative 12th-month were 60% versus 67%, p=0.644 for groups 1 and 2, respectively. First 3 months continence rates were 52.6% versus 72%, p=0.035 for groups 1 and group

2, respectively. Postoperative 12. month continence rates were similar for group 1 and 2(94.7% vs 97.3%; p=0.562).

Conclusion: RARP after TUR-P has similar oncological outcomes, longer operative time, worse postoperative early continence acquisition rates and longer urethral catheter removal time.

Keywords: Prostate cancer, robotic prostatec- tomy, TUR-P, previous surgery


Abstract

Objective: We investigated the impact of transurethral resection of the prostate (TUR-P) on perioperative outcomes in patients who underwent robot assisted radical prostatectomy (RARP).

Material and Methods: A total of 752 cases per- formed by 3 surgeons between February 2009 and December 2017 were reviewed retrospectively. First 100 cases of each surgeon were not included to ex- clude the learning curve effect. All patients (n = 452) were divided into two groups according to having a previous TUR-P history as Group 1 = patients with TUR-P history (n = 38), Group 2 = patients without TUR-P history (n = 414).

Results: Mean patient age was 68.3± 5.9 ver- sus 63.3±6.8 years p=0.00; mean console time was 144.3±37.1 versus 124.6±24.0 minutes, p=0.02; blad- der neck reconstruction was 31.6% versus 16.7%, p=0.02; transurethral catheter removal time was 11.3±5.1 versus 8.6±2.7 days, p=0.00; for groups 1 and 2, respectively. Positive surgical margin rates were 26.3% versus 27.3%, p=0.897; erectile func- tion (IIEF≥17) rates on postoperative 12th-month were 60% versus 67%, p=0.644 for groups 1 and 2, respectively. First 3 months continence rates were 52.6% versus 72%, p=0.035 for groups 1 and group

2, respectively. Postoperative 12. month continence rates were similar for group 1 and 2(94.7% vs 97.3%; p=0.562).

Conclusion: RARP after TUR-P has similar oncological outcomes, longer operative time, worse postoperative early continence acquisition rates and longer urethral catheter removal time.

Keywords: Prostate cancer, robotic prostatec- tomy, TUR-P, previous surgery

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