title: Importance of previous transurethral resection of the prostate before eerpe.short-term functional outcomes in a single surgeon series.
abstract: OBJECTIVE
  Laparoscopic Radical Prostatectomy (LRP) is technically a very demanding procedure and potentially even more challenging in patients with previous  transurethral resection (TURP). This study evaluates the impact of previous TURP on the short-term functional outcome of patients undergoing extraperitoneal  LRP.
  
  
  METHODS
  Retrospective analysis of a prospectively collected database, comprising a single-surgeon cohort of 155 consecutive LRP cases, 19 of which had previous history of TURP. Demographics, clinical and functional outcomes were evaluated and compared among patients with and without previous TURP. Multivariate analysis  was performed to identify potential variables independently associated with continence outcomes. Incontinence was defined as the need of more than 1 pad/day.  Potency was defined as the ability for sexual intercourse with or without the use of phosphodiesterase inhibitors.
  
  
  RESULTS
  Demographic and clinical variables were comparable among the two study groups. Neurovascular bundle preservation was possible in 26% and 37%   of patients  with and without previous TURP, respectively. No major complications were recorded and the incidence of minor complications was comparable. Overall continence  rate at 3 months was 82,58%, for the entire cohort. Subset analysis demonstrated a 3-month continence rate of 73.7% vs. 83.8%  (p>0.05)  in patients  with and without  TURP, respectively. Multivariate analysis demonstrated age, BMI and ASA were variables independently associated with continence outcomes. In the cohort of patients  with previous TURP, 2 out of 7 undergoing preservation recovered erections, with a mean follow up of 15.5 months, comparable to the 30% achieved in patients without TURP and nerve sparing procedure.
  
  
  CONCLUSIONS
  Laparoscopic Radical Prostatectomy in patients with previous TURP is feasible, with complication rates and short-term functional outcomes comparable  to those in patients without previous resection.
authors.affiliation: Urology Department, Fundación IVO, Valencia, Spain. ramirezbackhaus@yahoo.es
authors.forename: Miguel
authors.initials: M
authors.lastname: Ramírez Backhaus
authors.forename: Joaquín
authors.initials: J
authors.lastname: Juan Escudero
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Palmero Martí
authors.forename: Isabel M
authors.initials: IM
authors.lastname: Ortíz Rodríguez
authors.forename: José
authors.initials: J
authors.lastname: Rubio Briones
authors.forename: Jens-Uwe
authors.initials: JU
authors.lastname: Stolzenburg
authors.forename: Antonio
authors.initials: A
authors.lastname: Benedicto Redón
authors.forename: José
authors.initials: J
authors.lastname: Domínguez Escrig
authors.forename: Argimiro
authors.initials: A
authors.lastname: Collado Serra
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Gómez-Ferrer
authors.forename: Juan
authors.initials: J
authors.lastname: Casanova
authors.forename: Carmelo
authors.initials: C
authors.lastname: Rodríguez Torreblanca
authors.forename: Eduardo
authors.initials: E
authors.lastname: Solsona Narbón
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012725:Sexual Behavior; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014546:Urinary Catheterization