MP61-11 RETZIUS-SPARING ROBOT-ASSISTED RADICAL PROSTATECTOMY AFTER PREVIOUS TRANS-URETHRAL RESECTION OF THE PROSTATE: ASSESSMENT OF FUNCTIONAL AND ONCOLOGICAL OUTCOMES

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP61-11 RETZIUS-SPARING ROBOT-ASSISTED RADICAL PROSTATECTOMY AFTER PREVIOUS TRANS-URETHRAL RESECTION OF THE PROSTATE: ASSESSMENT OF FUNCTIONAL AND ONCOLOGICAL OUTCOMES Stefano Tappero, Enrico Vecchio, Erika Palagonia, Giorgia Granelli, Marco Martiriggiano, Ofir Maltzman, Alberto Olivero, Silvia Secco, Aldo Massimo Bocciardi, Antonio Galfano, and Paolo Dell'oglio Stefano TapperoStefano Tappero More articles by this author , Enrico VecchioEnrico Vecchio More articles by this author , Erika PalagoniaErika Palagonia More articles by this author , Giorgia GranelliGiorgia Granelli More articles by this author , Marco MartiriggianoMarco Martiriggiano More articles by this author , Ofir MaltzmanOfir Maltzman More articles by this author , Alberto OliveroAlberto Olivero More articles by this author , Silvia SeccoSilvia Secco More articles by this author , Aldo Massimo BocciardiAldo Massimo Bocciardi More articles by this author , Antonio GalfanoAntonio Galfano More articles by this author , and Paolo Dell'oglioPaolo Dell'oglio More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003319.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To date, no data exist concerning functional and oncological outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) in patients previously treated with trans-urethral resection of the prostate (p-TURP) for benign prostate obstruction. The current study aimed to address the impact of p-TURP on immediate and 12-months urinary continence recovery (UCR), as well as perioperative outcomes and surgical margins after RS-RARP. METHODS: Patients treated with RS-RARP for prostate cancer at a single high-volume European institution were identified and stratified according to p-TURP. Intraoperative and postoperative complications were reported according to EAU guidelines standardized methodology. Univariable and multivariable logistic, Poisson log-linear and Cox regression models were performed. RESULTS: Of 1,386 RS-RARP patients, 99 (7%) had history of p-TURP. According to EAU intraoperative adverse events classification (EAUiaiC), the most common intraoperative complications were EAUiaiC grade 1 (n=26/31, 84%). The most common postoperative complications were Clavien-Dindo grade 2 (n=67/174, 39%), and the most common reason of readmission was infected lymphocele (n=8/16, 50%). Between p-TURP and no-TURP patients no differences were detected in terms of rates of intraoperative complications (2 vs 2%), in-hospital postoperative complications (12 vs 11%), and readmissions (1 vs 1%; all p values≥0.8). At catheter removal, the rates of immediate UCR were 40 vs 67% in p-TURP vs no-TURP patients (p<0.001). At 12 months from RS-RARP, the rates of UCR were 68 vs 94% in p-TURP vs no-TURP patients (p<0.001). At multivariable logistic and Cox regression models, p-TURP was independently associated, respectively, with lower immediate (odds ratio [OR]: 0.32, p<0.001) and 12-months UCR (hazard ratio: 0.54, p<0.001). At multivariable Poisson analyses, p-TURP predicted longer operative time (rate ratio: 1.08, p<0.001) but not longer length of stay or time to catheter removal (p values>0.05). Positive surgical margins rates were 23 vs 17% in p-TURP vs no-TURP patients (p=0.1), which translated in a non significant multivariable OR of 1.14 (p=0.58). CONCLUSIONS: RS-RARP in patients with history of TURP for BPO may be longer and associated with worse urinary continence recovery both at bladder catheter removal and at subsequent time-points. In the current series, p-TURP patients harbored low complication rates, and surgical margins rates comparable to their no-TURP counterparts. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e856 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Stefano Tappero More articles by this author Enrico Vecchio More articles by this author Erika Palagonia More articles by this author Giorgia Granelli More articles by this author Marco Martiriggiano More articles by this author Ofir Maltzman More articles by this author Alberto Olivero More articles by this author Silvia Secco More articles by this author Aldo Massimo Bocciardi More articles by this author Antonio Galfano More articles by this author Paolo Dell'oglio More articles by this author Expand All Advertisement PDF downloadLoading ...