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.