Previous bladder outlet surgery does not affect medium-term outcomes after laparoscopic radical prostatectomy.
OBJECTIVE
To investigate the effect of previous bladder outlet surgery (BOS) on the peri-operative variables of patients having laparoscopic radical prostatectomy (LRP), as reported evidence as to whether BOS affects the outcome of RP is contradictory.


METHODS
Of 600 consecutive patients attending for LRP from March 2000 to January 2006, 558 had had no surgery (NS) and 42 (7.0%) had a history of BOS (transurethral prostatectomy in 35, 5.8%; bladder neck incision in seven, 1.2%). All patients had clinical stage < or = T3aN0M0 prostate cancer and had their procedure performed or supervised by the same surgeon.


RESULTS
Patients with previous BOS had a significantly greater age (mean 64.6 vs 61.8 years, P = 0.008), duration of catheterization (mean 13.7 vs 10.5 days, P = 0.003), proportion of pT3a tumours (16.7% vs 4.5%, P = 0.009) and potency rates at > or = 24 months (P < 0.001). Patients with previous BOS had a significantly lower body weight (mean 79.7 vs 83.0 kg, P = 0.05) and prostate weight (mean 46.7 vs 58.6 g, P = 0.01). Although patients with previous BOS had poorer continence at 3 months (61% vs 91%, P < 0.001), continence rates were similar in the two groups after this.


CONCLUSIONS
Previous BOS does not affect the medium-term outcomes after LRP.
Eden
Christopher G
CG
Department of Urology, The Royal Surrey County Hospital, Guildford, Surrey, UK. edenchristopher@gmail.com
Richards
Andrew J
AJ
Ooi
Jason
J
Moon
Daniel A
DA
Laczko
Istvan
I
D000368:Aged; D001835:Body Weight; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012086:Reoperation; D020728:Transurethral Resection of Prostate / Q000379:methods; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000601:surgery*