Farzat Mahmoud, Rosenbauer Josef, Tanislav Christian, Wagenlehner Florian M
Department of Urology and Robotic Urology, Diakonie Klinikum Siegen, Academic Teaching Hospital of the University of Bonn, 53127 Bonn, Germany.
Department of Urology, Pediatric Urology and Andrology, Justus-Liebig University of Giessen, 35390 Giessen, Germany.
J Clin Med. 2023 Mar 25;12(7):2491. doi: 10.3390/jcm12072491.
Elevated prostate volume is considered to negatively influence postoperative outcomes after robot-assisted radical prostatectomy (RARP). We aim to investigate the influence of prostate volume on readmissions and complications after RARP.
A total of 500 consecutive patients who underwent RARP between April 2019 and August 2022 were included. Patients were dichotomized into two groups using a prostate volume cut-off of 50 mL (small and normal prostate (SNP) n = 314, 62.8%; large prostate n = 186, 37.2%). Demographic, baseline, and perioperative data were analyzed. The postoperative complications and readmission rates within 90 days after RARP were compared between groups. A univariate linear analysis was performed to investigate the association between prostate volume and other relevant outcomes.
Patients with larger prostates had a higher IPSS score, and therefore, more relevant LUTS at the baseline. They had higher ASA scores ( = 0.015). They also had more catheter days (mean 6.6 days for SNP vs. 7.5 days for LP) ( = 0.041). All oncological outcomes were similar between the groups. Although statistical analysis showed no significant difference between the groups ( = 0.062), a trend for minor complications in patients with larger prostates, n = 37/186 (19.8%) for the LP group vs. n = 37/314 (11.7%) in the SNP group, was observed. Namely, acute urinary retention and secondary anastomosis insufficiency. Major complications with an SNP (4.4%) and LP (3.7%) ( = 0.708) and readmissions with an SNP (6.25%) and LP (4.2%) ( = 0.814) were infrequent and distributed equally between the groups. In univariate analysis, prostate volume could solely predict a longer console time ( = 0.005).
A higher prostate volume appears to have minimal influence on the perioperative course after RARP. It can prolong catheter days and increase the incidence of minor complications such as acute urinary retention. However, it might predict minor changes in operating time. Yet, prostate volume has less influence on major complications, readmissions, or oncological results.
前列腺体积增大被认为会对机器人辅助根治性前列腺切除术（RARP）后的术后结果产生负面影响。我们旨在研究前列腺体积对RARP术后再入院和并发症的影响。
纳入2019年4月至2022年8月期间连续接受RARP的500例患者。使用50 mL的前列腺体积临界值将患者分为两组（小前列腺和正常前列腺组（SNP）n = 314，占62.8%；大前列腺组n = 186，占37.2%）。分析人口统计学、基线和围手术期数据。比较RARP术后90天内两组的术后并发症和再入院率。进行单变量线性分析以研究前列腺体积与其他相关结果之间的关联。
前列腺较大的患者国际前列腺症状评分（IPSS）较高，因此在基线时存在更多相关的下尿路症状（LUTS）。他们的美国麻醉医师协会（ASA）评分较高（P = 0.015）。他们的导尿管留置天数也更多（SNP组平均为6.6天，LP组为7.5天）（P = 0.041）。两组之间所有肿瘤学结果相似。尽管统计分析显示两组之间无显著差异（P = 0.062），但观察到前列腺较大的患者出现轻微并发症的趋势，LP组为37/186（19.8%），SNP组为37/314（11.7%）。具体为急性尿潴留和继发性吻合口功能不全。SNP组（4.4%）和LP组（3.7%）的严重并发症（P = 0.708）以及SNP组（6.25%）和LP组（4.2%）的再入院情况（P = 0.814）并不常见，且在两组之间分布均匀。在单变量分析中，前列腺体积只能预测更长的控制台操作时间（P = 0.005）。
较高的前列腺体积似乎对RARP术后的围手术期过程影响最小。它可延长导尿管留置天数并增加急性尿潴留等轻微并发症的发生率。然而，它可能预示手术时间有轻微变化。不过，前列腺体积对严重并发症、再入院或肿瘤学结果的影响较小。
