title: Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP?
abstract: 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.
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. kevinsu168@gmail.com.
authors.forename: Yu-Kai
authors.initials: YK
authors.lastname: Su
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. benjaminfkatz@gmail.com.
authors.forename: Benjamin F
authors.initials: BF
authors.lastname: Katz
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. Shailen.Sehgal@uphs.upenn.edu.
authors.forename: Shailen S
authors.initials: SS
authors.lastname: Sehgal
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA.
authors.forename: Sue-Jean S
authors.initials: SJ
authors.lastname: Yu
authors.affiliation: Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. ego168@gmail.com.
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Su
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. andrewlightfoot70@gmail.com.
authors.forename: Andrew
authors.initials: A
authors.lastname: Lightfoot
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. Ziho.Lee@gmail.com.
authors.forename: Ziho
authors.initials: Z
authors.lastname: Lee
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. Elton.Llukani@uphs.upenn.edu.
authors.forename: Elton
authors.initials: E
authors.lastname: Llukani
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. Kelly.Monahan@uphs.upenn.edu.
authors.forename: Kelly
authors.initials: K
authors.lastname: Monahan
authors.affiliation: Department of Urology, University of Pennsylvania Health System, Penn Presbyterian Medical Center, University of Pennsylvania, 300 Medical Office Building, 51 North 39th Street, Philadelphia, PA, 19104, USA. david.i.lee@uphs.upenn.edu.
authors.forename: David I
authors.initials: DI
authors.lastname: Lee
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D011795:Surveys and Questionnaires; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: Continence outcomes; Prostate cancer; Robotic prostatectomy; TURP; Transurethral prostate surgery