The 'prostate-muscle index': a simple pelvic cavity measurement predicting estimated blood loss and console time in robot-assisted radical prostatectomy.

Journal: Scientific reports
Published Date:

Abstract

This study was to show the impact of 'prostate-muscle index (PMI)', which we developed as a novel pelvic cavity measurement, in patients undergoing robot-assisted radical prostatectomy (RARP). We defined PMI as the 'distance between the inner edge of the obturator internus muscle and the lateral edge of the prostate at the magnetic resonance imaging (MRI) slice showing the maximum width of the prostate'. Seven hundred sixty patients underwent RARP at the University of Tokyo Hospital from November 2011 to December 2018. MRI results were unavailable in 111 patients. In total, 649 patients were eligible for this study. Median values of blood loss and console time were 300 mL and 168 min. In multivariate analysis, body mass index (BMI), prostate volume-to-pelvic cavity index (PV-to-PCI), PMI, and surgical experience were significantly associated with blood loss > 300 mL (P = 0.0002, 0.002, < 0.0001, and 0.006 respectively). Additionally, BMI, PMI, and surgical experience were also significantly associated with console time > 160 min in multivariate analysis (P = 0.04, 0.004, and < 0.0001, respectively). In conclusion, PMI may provide useful information to surgeons and patients in preoperative decision-making.

Authors

  • Naoki Kimura
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Yuta Yamada
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan.
  • Yuta Takeshima
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Masafumi Otsuka
    Aoi-Clinic, Yokohama City, Kanagawa, Japan.
  • Nobuhiko Akamatsu
    Department of Radiology, Nerima Hikarigaoka Hospital, Nerima-Ku, Tokyo, Japan.
  • Yuji Hakozaki
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Jimpei Miyakawa
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Yusuke Sato
    Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Japan.
  • Yoshiyuki Akiyama
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Daisuke Yamada
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tetsuya Fujimura
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan. fujimurat-uro@h.u-tokyo.ac.jp.
  • Haruki Kume
    Department of Urology, Graduate School of Medicine, The University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo, Japan.