Laparoscopic radical prostatectomy after previous transurethral resection of prostate using a catheter balloon inflated in prostatic urethra: Oncological and functional outcomes from a matched pair analysis.

Abstract

To explore the surgical, oncological and functional outcomes of laparoscopic radical prostatectomy in patients who have undergone transurethral resection of the prostate, using a catheter balloon inflated in the prostatic urethra. A total of 25 patients were randomly assigned to the no balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy group (n = 12) and the with balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy group (n = 13). Two matched pairs analyses were carried out to identify the 12 (control A) and 13 (control B) surgery-naïve patients. The outcomes were compared between the groups with previous transurethral resection of the prostate (no balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy and with balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy groups) and the controls. The rate of intra- and postoperative complications was assessed. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and the International Index of Erectile Function 5 were used for symptoms evaluation. The mean blood loss was higher in patients submitted to transurethral resection of the prostate, with statistically insignificant reduced blood loss in the with balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy group. The no balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy group had longer operative time compared with both the with balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy and control A groups (P < 0.05). International Index of Erectile Function 5 showed a significant difference between no balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy and its control group; the International Consultation on Incontinence Questionnaire showed a statistically significant difference (P < 0.05) between the no balloon previous transurethral resection of the prostate laparoscopic radical prostatectomy and control A groups. The use of a catheter balloon inflated in the prostatic urethra seems to facilitate laparoscopic radical prostatectomy in patients with previous transurethral resection of the prostate, ultimately reducing the rate of perioperative complications. These findings warrant further investigation on a larger case series with a longer follow up.