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Outcomes of robot‐assisted radical prostatectomy in men with previous transurethral resection of prostate
Author(s) -
Gupta Narmada P.,
Singh Prabhjot,
Nayyar Rishi
Publication year - 2011
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2011.10113.x
Subject(s) - medicine , prostatectomy , urology , prostate cancer , neck of urinary bladder , transurethral resection of the prostate , prostate , surgery , cancer , urinary bladder
Study Type – Therapy (case series) Level of Evidence 4 OBJECTIVE • To critically analyze and compare surgical, oncological and functional outcomes of robot‐assisted radical prostatectomy (RARP) in patients with and without previous transurethral resection of prostate (TURP). PATIENTS AND METHODS • The study comprised 158 cases of RARP for clinically localized prostate cancer, including 26 cases that had undergone previous TURP (Group A). • Surgical, oncological and functional (short‐ and intermediate‐term) outcomes of Group A were compared with 132 cases without previous TURP (Group B). RESULTS • Post TURP patients were found to have significantly greater blood loss (494 vs 324 mL) and a need for bladder neck reconstruction (26.7% vs 9.7%) compared to the non‐TURP group. • Surgical time (189 vs 166 min), conversion rate, margin positivity rate and biochemical recurrence rate were also higher. • Incontinence rates were higher both at 6 (14% vs 11.8%) and 12 (25% vs 8%) months follow‐up. CONCLUSIONS • RARP is feasible but challenging after TURP. It entails a longer operating time, greater operative difficulty and compromised oncological or continence outcomes. • These cases should be handled by an experienced robotic surgeon with the appropriate expertise.