Does a history of previous surgery or radiation to the prostate affect outcomes of robot-assisted radical prostatectomy?
OBJECTIVE
To evaluate retrospectively whether or not previous treatment to the prostate alters the perioperative outcomes from robot-assisted radical prostatectomy (RARP) after the initial 'learning curve', as there are conflicting data on outcomes of RP in patients with previous treatment to the prostate.


METHODS
We retrospectively reviewed the charts of patients who had RARP between March 2005 and August 2007, and analysed demographic, perioperative variables and pathological data. In all, 510 patient charts were reviewed, identifying 24 patients with a history of previous treatment to the prostate including transurethral resection or incision of the prostate, transurethral microwave therapy, transurethral needle ablation, photoselective vaporization, simple prostatectomy, external beam radiotherapy, brachytherapy, and open bladder neck reconstruction (group 1) and 486 with no previous treatment (group 2).


RESULTS
There was no significant difference between the groups in body mass index, clinical stage, grade or prostate volume, but the patients in group 1 were older (70 vs 65 years, P = 0.001). Outcome analysis comparing groups 1 and 2 showed an estimated blood loss of 155 vs 137 mL, length of hospital stay of 2.2 vs 1.5 days, operative duration of 200 vs 186 min and catheter time of 12 vs 8 days, respectively; only the last was statistically significant (P = 0.03). There was an 8.3% and 6.8% complication rate in groups 1 and 2, respectively, and the respective overall positive margin rate was 20.8% and 22.6%.


CONCLUSIONS
A history of previous treatment of the prostate does not appear to compromise the perioperative outcomes of RARP.
Martin
Aaron D
AD
Department of Urology, Mayo Clinic, Phoenix, AZ 85054, USA. martin.aaron@mayo.edu
Desai
Premal J
PJ
Nunez
Rafael N
RN
Martin
George L
GL
Andrews
Paul E
PE
Ferrigni
Robert G
RG
Swanson
Scott K
SK
Pacelli
Anna
A
Castle
Erik P
EP
D000368:Aged; D015992:Body Mass Index; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D011467:Prostate / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D011469:Prostatic Diseases / Q000532:radiotherapy / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012371:Robotics; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome