SELİM TAS, SAHİN KİLİC
Grand Journal of Urology -
Objective: To examine the relationship between prostate weight and oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). Materials and Methods: Data of the patients who underwent RS-RARP in our clinic between December 2018 and December 2020 were evaluated retrospectively. A total of 106 patients with 12-month postoperative follow-up data were included in the study. The patients were separated into 2 groups according to the weights of the pathology specimens as Group 1 (n=53, prostate weight less than 50 g), and Group 2 (n=53, prostate weight more than 50 g). Postoperative oncological and functional data were analyzed. At the end of the 12th month, continence was regarded as requirement of no pad or 1 pad per day. Potency was considered as the ability to have sexual intercourse. Prostate-specific antigen (PSA) above 0.2 ng/ml in the follow-up period was considered as biochemical recurrence. Results: Preoperative PSA levels were comparable between groups (9.78+7.84 ng/ml vs. 11.87+8.38 ng/ml). There was no difference in clinical cancer stages and The International Society of Urological Pathology (ISUP) scores between the groups. Median vesicourethral anastomosis time (30 minvs.33 min) and median operative time (240 min vs. 240 min) were comparable in both groups (p>0.05). There was no difference in localized disease and locally advanced disease rates between the groups (pT2: 58.5% vs. 67.9%, pT3: 41.5% vs. 32.0%). Surgical margin positivity (SMP) ([16.9% (n=9) vs 9.4% (n=5]), and 12th month biochemical recurrence rates (11.32% vs 3.77%) were similar in groups 1 and 2 (p>0.05). Postoperative urinary continence rates at 12 months were 89% and 90% in Groups 1 and 2, respectively (p>0.05). Continence status was not different between the groups. Potency rates at 12 months were comparable between the groups. Conclusion: RS-RARP can be applied in patients with any size of prostates with comparable functional and oncological outcomes.