The effects of pelvic dimensions on radical retropubic prostatectomy.

INTRODUCTION

To determine the effects of pelvic dimensions on margin status, preoperative and postoperative estimated blood loss (EBL), operative time and transfusion rate (TR) during radical retropubic prostatectomy (RRP).

MATERIALS AND METHODS

Data from 94 patients with preoperative prostate MRI were analyzed. Pelvic dimensions, including interspinous distance (ISD), bony (BFW) and soft tissue (SW) pelvic width, apical prostate depth, upper conjugate (UC), lower conjugate (LC) were measured by preoperative MRI. Indexes for pelvic dimensions (PDI), bony width (BWI) and soft-tissue width (SWI) were defined as ISD/AD, BFW/PD, and SW/AD, respectively. As indicators of surgical difficulty, TR and EBL were assessed. SPSS version 17.0 was used for statistical analyses.

RESULTS

Correlational analysis revealed no significant relationship between pelvic dimensions and parameters reflecting operative difficulty (p > 0.05). For EBL, there were significant indirect correlations between the BFW/AD, ISD/AD, and SW/AD indexes (p < 0.01, p < 0.01, p < 0.05; respectively). Additionally, the correlations between AD and TR (p < 0.05) and between AD and EBL (p < 0.05) were significant. Consequently, TR was significantly correlated with BFW/AD, ISD/AD and SW/AD (p < 0.01, p < 0.05, p < 0.01; respectively). Correlational analysis revealed that prostate volume (PV) was significantly correlated with EBL and TR (p < 0.01). Multivariate analyses revealed that PV was a significant predictor of TR (p = 0.06). None of the pelvic dimensions were significantly associated with recovery of urinary continence (RUC) (p > 0.05).

CONCLUSIONS

Analyses of pelvic dimensions as significant factors influencing operative difficulty during RRP yielded mixed results. PV seems to be the strongest factor related to operative difficulty. Future studies about pelvic dimensions should be conducted.