Boylu Uğur, Turan Turgay, Başataç Cem, Fatih Önol Fikret, Gümüş Eyüp
Department of Urology, Ümraniye Training and Research Hospital, İstanbul, Turkey.
Turk J Urol. 2013 Dec;39(4):209-13. doi: 10.5152/tud.2013.055.
The effect of prostate volume on the surgical, functional, and oncological outcomes of robot assisted radical prostatectomy (RARP) was evaluated.
A total of 180 patients who underwent RARP and had at least a 1-year follow-up were included. The patients were divided into 3 groups based on prostate weight (Group 1: <45 g, Group 2: 45-75 g, and Group 3: >76 g). Erectile function and continence were evaluated at 3, 6, 9, and 12 months postoperatively. The International Index of Erectile Dysfunction (IIEF) score and daily pad usage were evaluated as indicators of erectile function and continence, respectively. The measurement of two prostate-specific antigen (PSA) values over 0.2 ng/mL was considered biochemical disease recurrence.
Patients with larger prostates were older and had a longer operative time and higher PSA level compared with patients with smaller prostates (p<0.05). The positive surgical margin rate was higher in patients with smaller prostates (p=0.06). However, patients with a prostate weight <45 g had higher IIEF scores at 3 and 6 months. IIEF scores were similar at the end of the 1-year follow-up period. Pad usage and time to continence were higher in patients with larger prostates (p>0.05).
Although prostate weight affected the surgical outcomes of RARP, the functional and oncological outcomes were similar among all patients. Long-term follow-up is needed to determine their impact on oncological outcomes.
评估前列腺体积对机器人辅助根治性前列腺切除术(RARP)的手术、功能及肿瘤学结局的影响。
纳入总共180例行RARP且至少随访1年的患者。根据前列腺重量将患者分为3组(第1组:<45 g,第2组:45 - 75 g,第3组:>76 g)。术后3、6、9和12个月评估勃起功能和控尿情况。分别将国际勃起功能障碍指数(IIEF)评分和每日使用尿垫情况作为勃起功能和控尿的指标。两次前列腺特异性抗原(PSA)值测量超过0.2 ng/mL被视为生化疾病复发。
与前列腺较小的患者相比,前列腺较大的患者年龄更大,手术时间更长,PSA水平更高(p<0.05)。前列腺较小的患者阳性手术切缘率更高(p = 0.06)。然而,前列腺重量<45 g的患者在术后3个月和6个月时IIEF评分更高。在1年随访期结束时IIEF评分相似。前列腺较大的患者尿垫使用情况和达到控尿的时间更长(p>0.05)。
尽管前列腺重量影响RARP的手术结局,但所有患者的功能和肿瘤学结局相似。需要长期随访以确定其对肿瘤学结局的影响。