Open radical retropubic prostatectomy gives favourable surgical and functional outcomes after transurethral resection of the prostate.
OBJECTIVE
To assess the peri- and postoperative outcome of patients treated with open radical retropubic prostatectomy (RRP) for prostate cancer and who had previously undergone transurethral resection of the prostate (TURP).


METHODS
Prospectively collected data from a consecutive series of 1760 patients who had RRP between July 2003 and June 2007 at our institution were used to retrospectively match 62 cases (with previous TURP) with the same number of controls (without previous TURP). Matching variables were patient age, body mass index, prostate volume, preoperative total prostate-specific antigen (PSA) level, Gleason score, pathological stage, and intraoperative nerve-sparing procedure. Complete 1-year follow-up data were available for all patients. All collected data on surgery and perioperative complications were analysed. Functional outcome data at the 1-year follow-up were evaluated by applying an institutional questionnaire. Sexual function was assessed using the abbreviated International Index of Erectile Function-5 questionnaire, and urinary control was evaluated by defining complete urinary control as no pad usage.


RESULTS
The rate of complete urinary control rate in cases and controls was similar (81% vs 82%). When nerves were spared, 60% (15/25) of patients in either group were capable of sexual intercourse. The overall positive surgical margin rate was insignificantly higher in cases (19% vs 13, P>0.05). After 1 year of follow-up the biochemical recurrence rate (PSA>0.04 ng/mL) did not differ significantly in patients who had RRP after TURP vs RRP alone (six of 62, 10%, vs five of 62, 8%; P=0.77).


CONCLUSIONS
RRP for prostate cancer in patients who have had previous TURP does not result in a higher perioperative complication rate, or a worse functional outcome.
Palisaar
Jüri R
JR
Department of Urology, Ruhr-University Bochum, Marienhospital, Herne, Germany. palisaar@t-online.de
Wenske
Sven
S
Sommerer
Florian
F
Hinkel
Andreas
A
Noldus
Joachim
J
D000328:Adult; D000368:Aged; D004812:Epidemiologic Methods; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology
D017430:Prostate-Specific Antigen