Type and Screen Prior to Radical Prostatectomy for Prostate Cancer-Time for a Change?

Purpose: Despite low rates of transfusion associated with robotic prostatectomy, surgeons routinely obtain preoperative blood typing. Here we aim to understand the cost savings associated with eliminating blood typing prior to prostatectomy. Materials and Methods: A retrospective review of our single surgeon radical prostatectomy database was performed. Patients receiving blood transfusions within 3 days of prostatectomy were identified and clinical characteristics were recorded. Cost information was obtained, and descriptive statistical analysis performed. Results: 1,581 patients underwent prostatectomy from 2000 to 2019. Thirty-two patients (2.02%) received a transfusion within 3 days of surgery. The transfusion rate for open prostatectomy was 3.21% vs 1.37% for robotic prostatectomy. The cost of preoperative blood typing for all radical prostatectomies was $113,832, or about $5,812.70 per year. Conclusions: Transfusion rates for prostatectomy are low and decline with experience. Significant cost savings is possible by avoiding routine preoperative blood typing in most patients undergoing radical prostatectomy.