Does the Timing of Performing Robot-assisted Radical Prostatectomy after Prostate Biopsy Affect the Outcome?

Abstract

Purpose: Prostate biopsy induced prostate hemorrhage and periprostate tissue inflammation which raised the concerns of increasing difficulty even in the era of robot-assisted radical prostatectomy (RARP). To evaluate the correlation between postoperative outcomes and the interval after biopsy, we compared surgical outcomes in different time interval (≤4 weeks, 4–8 weeks, and ≥8 weeks). Materials and Methods: We collected patients with localized prostate cancer who underwent RARP by a single experienced surgeon at our institute between April 2016 and February 2019. The complicated statuses such as previously transurethral resection of prostate, grossly nodal positive disease, or locally advanced disease were excluded. A total of 83 patients were enrolled retrospectively according to the regulation of the institutional review board in the institute. The patients were divided into three groups according to the time interval between prostate biopsy and RARP (≤4 weeks, 4-8 weeks and ≥ 8 weeks). The demographic information and perioperative and postoperative outcomes were collected and analyzed. Results: Regarding preoperative characteristics, there were similarities in the three groups. Concerning intraoperative outcomes, statistical difference was observed in mean estimated blood loss (253.1 vs. 158.9 vs. 170.9 ml, P= 0.047). In addition, operative time was similar among three groups (221.9 vs. 248.5 vs. 226.7, P= 0.199). There was no difference in positive surgical margin rate among three groups. The time interval groups did not correlate to prolonged days either urinary catheter indwelling or hospitalization (P > 0.05). There was no difference in decreased erection hardness scores at 12 months between 3 groups (−0.75 vs. −0.77 vs. −0.57, P= 0.556). Conclusion: In our experience, RARP can be effectively and safely performed in different time intervals after prostate biopsy without increasing total operative time or adversely compromising postoperative functionally and oncologic outcomes. However, performing RARP < 4 weeks after prostate biopsy did probably have the risk of increase estimated blood loss.