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Outcomes of robot-assisted radical prostatectomy in men after trans-urethral resection of the prostate: a matched-pair analysis

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Abstract

Prior history of transurethral resection of the prostate (TURP) can complicate Robot-assisted radical prostatectomy (RARP). Very few studies analyse the outcomes of RARP in men with a prior history of TURP. We analysed the oncological and functional outcomes of RARP in post-TURP men from our prospectively maintained database. We included the RARP data from January 2016 to January 2022. Thirty men who had RARP with a prior history of TURP were identified (Group 2). They were matched using R software and propensity score matching to 90 men with no previous TURP (Group-1). The groups were matched for age, body mass index (BMI), Gleason score, stage, PSA and D’Amico risk category in a 1:3 ratio. The two-year oncological and functional outcomes were compared. Overall, the study found no significant difference between the groups in the preoperative parameters, such as BMI, age, Gleason grade, clinical stage, PSA, prostate volume, and D’amico risk grouping. There was no difference in the estimated blood loss. The TURP group had a lower chance of having a nerve spare (p = 0.03). The median console time was longer in the TURP group (140 min (120,180) versus 168 (129,190) p = 0.058). The postoperative complications (Clavien-Dindo 3a 2% versus 6.7%) and hospital stay (median of 2 days), positive surgical margins, continence, and biochemical recurrence rates at 3, 12, and 24 months were not statistically different between the groups. In high-volume centres, the oncological and continence outcomes of RARP post-TURP are not inferior to that of men without prior TURP.

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Funding

No funding was received to conduct the study.

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Authors and Affiliations

  1. Department of Urology, Royal Surrey County Hospital, Guildford, GU2 7XX, UK

    Danny Darlington Carbin, Wissam Abou Chedid & Christopher Eden

  2. Department of Urology, Hampshire Hospitals, Basingstoke, UK

    Richard Hindley

Authors
  1. Danny Darlington Carbin
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  2. Wissam Abou Chedid
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  3. Richard Hindley
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  4. Christopher Eden
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by DDC, WAC, RH and CE. DDC co-ordinated with the statistical team for analysis and wrote the first draft of the manuscript, and all authors commented on previous versions. All the authors have read the final manuscript before submission to the journal.

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Correspondence to Danny Darlington Carbin.

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All the authors declare that they have no conflict of interest.

Ethical clearance

This study was conducted as an audit in our department. Audit number: SU-CA-23-24-062.

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Carbin, D.D., Abou Chedid, W., Hindley, R. et al. Outcomes of robot-assisted radical prostatectomy in men after trans-urethral resection of the prostate: a matched-pair analysis. J Robotic Surg 18, 158 (2024). https://doi.org/10.1007/s11701-024-01935-5

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  • DOI: https://doi.org/10.1007/s11701-024-01935-5

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