Skip to main content

Advertisement

SpringerLink
Log in

Impact of previous transurethral resection of prostate on robot-assisted radical prostatectomy: a matched cohort analysis

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

We aimed to compare surgical, oncological, and functional outcomes of robot-assisted radical prostatectomy (RARP) in prostate cancer patients with and without prior history of transurethral resection of the prostate (TURP), using a matched cohort analysis. In an IRB-approved protocol, all patients who underwent RARP at our institution between April 2005 and July 2018 with at least 1-year follow-up were included. Among these, patients who had undergone a previous TURP (Group A) were compared with those without TURP (Group B) using the Survival, Continence, and Potency outcomes reporting system. Using propensity score matching for age, PSA and Gleason score, the two cohorts were further subdivided in a 1:2 ratio into Group C (prior TURP from Group A) and Group D (without prior TURP from Group B). Similar comparisons were made between Group C and D. Patients in Group A (n = 40) had lower PSA (p = 0.031) and were more likely to have Gleason grade 1 disease (p = 0.035) than patients in Group B (n = 143). In the propensity-matched group analysis, patients of Group C (n = 38) had higher operative time and blood loss than Group D (n = 76) patients. Group C patients also had lower continence at 3, 6, and 12 months after surgery. However, oncological and potency outcomes were similar in both the groups. We concluded that previous TURP is a predictor for surgical and continence outcomes following RARP. Even though these patients have a potentially lower stage or grade of disease, they are less likely to achieve social continence than men who have not had a previous TURP. This information would be important in counseling them for treatment options.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and material

The authors confirm the availability of and access to all data reported in this study.

Code availability

Appropriate codes were used to maintain patient confidentiality in data management software.

References

  1. Chopra S, Srivastava A, Tewari A (2012) Robotic radical prostatectomy: the new gold standard. Arab J Urol 10(1):23–31

    Article  Google Scholar 

  2. Gupta NP, Singh P, Nayyar R (2011) Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate. BJU Int 108(9):1501–1505

    Article  Google Scholar 

  3. Acar Ö, Esen T (2014) Robotic radical prostatectomy in patients with previous prostate surgery and radiotherapy. Prostate Cancer 2014:1–9

    Article  Google Scholar 

  4. Li H, Zhao C, Liu P, Hu J, Yi Z, Chen J et al (2019) Radical prostatectomy after previous transurethral resection of the prostate: a systematic review and meta-analysis. Transl Androl Urol 8(6):712–727

    Article  Google Scholar 

  5. Su Y-K, Katz BF, Sehgal SS, Yu S-JS, Su Y-C, Lightfoot A et al (2015) Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP? J Robot Surg 9(4):291–297

    Article  Google Scholar 

  6. Zugor V, Labanaris AP, Porres D, Witt JH (2012) Surgical, oncologic, and short-term functional outcomes in patients undergoing robot-assisted prostatectomy after previous transurethral resection of the prostate. J Endourol 26(5):515–519

    Article  Google Scholar 

  7. Ficarra V, Sooriakumaran P, Novara G, Schatloff O, Briganti A, Van der Poel H et al (2012) Systematic review of methods for reporting combined outcomes after radical prostatectomy and proposal of a novel system: the survival, continence, and potency (SCP) classification. Eur Urol 61(3):541–548

    Article  Google Scholar 

  8. Menon M, Tewari A, Peabody JO, Shrivastava A, Kaul S, Bhandari A et al (2004) Vattikuti Institute prostatectomy, a technique of robotic radical prostatectomy for management of localized carcinoma of the prostate: experience of over 1100 cases. Urol Clin N Am 31(4):701–717

    Article  Google Scholar 

  9. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM (1999) Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 11(6):319–326

    Article  CAS  Google Scholar 

  10. Bianchi L, Nini A, Bianchi M, Gandaglia G, Fossati N, Suardi N et al (2016) The role of prostate-specific antigen persistence after radical prostatectomy for the prediction of clinical progression and cancer-specific mortality in node-positive prostate cancer patients. Eur Urol 69(6):1142–1148

    Article  CAS  Google Scholar 

  11. Colombo R, Naspro R, Salonia A, Montorsi F, Raber M, Suardi N et al (2006) Radical prostatectomy after previous prostate surgery: clinical and functional outcomes. J Urol 176(6):2459–2463

    Article  Google Scholar 

  12. Hampton L, Nelson RA, Satterthwaite R, Wilson T, Crocitto L (2008) Patients with prior TURP undergoing robot-assisted laparoscopic radical prostatectomy have higher positive surgical margin rates. J Robot Surg 2(4):213–216

    Article  Google Scholar 

  13. Tugcu V, Atar A, Sahin S, Kargi T, Gokhan Seker K, IlkerComez Y et al (2015) Robot-assisted radical prostatectomy after previous prostate surgery. JSLS 19(4):e2015.00080

    Article  Google Scholar 

  14. Hung C-F, Yang C-K, Ou Y-C (2014) Robotic assisted laparoscopic radical prostatectomy following transurethral resection of the prostate: perioperative, oncologic and functional outcomes. Prostate Int 2(2):82–89

    Article  Google Scholar 

  15. Jaffe J, Stakhovsky O, Cathelineau X, Barret E, Vallancien G, Rozet F (2007) Surgical outcomes for men undergoing laparoscopic radical prostatectomy after transurethral resection of the prostate. J Urol 178(2):483–487 (discussion 487)

    Article  Google Scholar 

  16. Ficarra V, Novara G, Secco S, D’Elia C, Boscolo-Berto R, Gardiman M et al (2009) Predictors of positive surgical margins after laparoscopic robot assisted radical prostatectomy. J Urol 182(6):2682–2688

    Article  Google Scholar 

Download references

Acknowledgements

We acknowledge Ms Anupama Raman, Nursing Officer in-charge of operative records, for helping with the database retrieval.

Funding

No funding or research support has been obtained for this study.

Author information

Authors and Affiliations

  1. Department of Urology, All India Institute of Medical Sciences, New Delhi, India

    Harshit Garg, Amlesh Seth & Rajeev Kumar

Authors
  1. Harshit Garg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amlesh Seth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rajeev Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All the authors have contributed in the research work and preparation of the manuscript as per International Committee of Medical Journal Editors (ICMJE) guidelines. HG: definition of intellectual content, literature search, clinical studies, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing, and manuscript review. AS: concepts, design, definition of intellectual content, literature search, manuscript editing, and manuscript review. RK: concepts, design, definition of intellectual content, literature search, clinical studies, manuscript preparation, manuscript editing, manuscript review, and guarantor (only one).

Corresponding author

Correspondence to Rajeev Kumar.

Ethics declarations

Conflict of interest

The authors declare no conflicts of interests.

Ethics approval

The study was reviewed and approved by Institute Ethics Review Board (IRB number: IRB number: IECPG-402/30.08.2018).

Consent to participate

An informed written consent was taken from all the patients included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Garg, H., Seth, A. & Kumar, R. Impact of previous transurethral resection of prostate on robot-assisted radical prostatectomy: a matched cohort analysis. J Robotic Surg 16, 1123–1131 (2022). https://doi.org/10.1007/s11701-021-01348-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-021-01348-8

Keywords

Search

Navigation