Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP?

被引：16

作者：

Su Y.-K. ^{[1
]}

Katz B.F. ^{[1
]}

Sehgal S.S. ^{[1
]}

Yu S.-J.S. ^{[1
]}

Su Y.-C. ^{[2
]}

Lightfoot A. ^{[1
]}

Lee Z. ^{[1
]}

Llukani E. ^{[1
]}

Monahan K. ^{[1
]}

Lee D.I. ^{[1
]}

机构：

[1] Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, 19104, PA

[2] Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA

来源：

Journal of Robotic Surgery | 2015年 / 9卷 / 4期

关键词：

Continence outcomes; Prostate cancer; Robotic prostatectomy; Transurethral prostate surgery; TURP;

D O I：

10.1007/s11701-015-0529-9

中图分类号：

学科分类号：

摘要：

We examined the effect of previous transurethral resection of the prostate (TURP) on multiple oncologic and continence outcomes after robotic-assisted radical prostatectomy (RARP). We performed a retrospective cohort study of a total of 2693 patients from 2007 to 2014 who underwent RARP. Patients were stratified into 49 patients who had previous TURP prior to RARP (group 1) and 2644 patients who had no TURP prior to RARP (group 2). We collected operative variables including estimated blood loss, operative time, and positive surgical margin (PSM) rates. Urinary continence, defined as 0 pads per day (PPD), and social continence, defined as 1-PPD, were also assessed. American Urological Association Symptoms Score (AUASS), overall ability to function sexually, and Expanded Prostate Cancer Index Composite (EPIC) questionnaire were evaluated at 3 and 12 months after RARP. Weakness of urinary stream (EPIC #4d) at 12 months imposed a greater problem for group 1 patients with prior TURP compared to group 2 patients without prior TURP (p = 0.012). PSM was not statistically significant between the two groups (p = 0.110). Group 1 patients had a greater PSM rate (30.61 %) as compared to group 2 (20.95 %). PSM locations in group 1 patients showed the most common locations at the posterior and apex. The difference between the two groups for AUASS, overall sexual function, estimated blood loss, operative time, urinary continence, and social continence was not statistically significant. We examined the effect of previous TURP on postoperative RARP continence and oncologic outcomes. This data can be used to counsel those with prior TURP before RARP. © 2015, Springer-Verlag London.

引用

页码：291 / 297

页数：6

共 19 条

[1]

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

[2]

Campbell M.F., Et al., Campbell-Walsh urology, (2012)

[3]

Martin A.D., Et al., Does a history of previous surgery or radiation to the prostate affect outcomes of robot-assisted radical prostatectomy?, BJU Int, 103, 12, pp. 1696-1698, (2009)

[4]

Bernstein A.J., Et al., Robotic assisted laparoscopic prostatectomy after TURP: a multi-institutional analysis of oncologic and quality of life outcomes, J Urol, 179, 4, (2008)

[5]

Ramon J., Et al., Morbidity of radical retropubic prostatectomy following previous prostate resection, J Surg Oncol, 55, 1, pp. 14-19, (1994)

[6]

Katz R., Et al., Laparoscopic radical prostatectomy in patients following transurethral resection of the prostate, Urol Int, 77, 3, pp. 216-221, (2006)

[7]

Bujons Tur A., Et al., Radical prostatectomy in patients with history of transurethral resection of the prostate, Arch Esp Urol, 59, 5, pp. 473-478, (2006)

[8]

Bandhauer K., Senn E., Radical retropubic prostatectomy after transurethral prostatic resection, Eur Urol, 15, 3-4, pp. 180-181, (1988)

[9]

Leewansangtong S., Taweemonkongsap T., Is laparoscopic radical prostatectomy after transurethral prostatectomy appropriated?, J Med Assoc Thai, 89, 8, pp. 1146-1149, (2006)

[10]

Jaffe J., Et al., Surgical outcomes for men undergoing laparoscopic radical prostatectomy after transurethral resection of the prostate, J Urol, 178, 2, pp. 483-487, (2007)

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