Robot-Assisted Radical Prostatectomy After Prior Transurethral Resection of Prostate: An Analysis of Perioperative, Functional, Pathologic, and Oncologic Outcomes.
Journal:
Journal of endourology
PMID:
35473411
Abstract
We performed a retrospective comparison of surgical, oncologic, and functional outcomes after robot-assisted radical prostatectomy between patients who have undergone prior transurethral resection of prostate (TURP) to TURP-naive patients. Past robotic prostatectomy hospital data were scrutinized to form two matched groups of patients: those who have undergone prior TURP and TURP-naive patients. The perioperative and pathologic data along with functional and oncologic outcomes for a period of 3 years were compared between groups. Compared with TURP-naive patients, prior TURP patients experienced longer robot-assisted laparoscopic prostatectomy times ( < 0.001), increased incidence of bladder neck reconstruction ( = 0.03), greater blood loss ( = 0.0001), and lesser nerve sparing ( < 0.01). Complication rates ( = 0.3), positive surgical margin ( = 0.4), extracapsular disease ( = 0.3), or seminal vesicle invasion ( = 0.1) were comparable between groups. Continence ( = 0.5) and potency ( = 0.1) at 1 year were not different between groups. Biochemical recurrence rates were not different at 3 years ( = 0.9). Diabetes slowed recovery of continence in patients with prior TURP compared with TURP-naive patients until 6 months after surgery. Although prior TURP makes subsequent robotic prostatectomy more technically demanding, it can be safely performed by experienced surgeons without compromising long-term functional or oncologic outcomes.