Previous bladder outlet surgery does not affect medium-term outcomes after laparoscopic radical prostatectomy.

Area of Science:

• Urology
• Surgical Oncology
• Medical Technology

Background:

• Evidence regarding the impact of prior bladder outlet surgery (BOS) on radical prostatectomy (RP) outcomes is conflicting.
• Laparoscopic radical prostatectomy (LRP) is a common treatment for prostate cancer.

Purpose of the Study:

• To evaluate the effect of previous bladder outlet surgery (BOS) on peri-operative variables in patients undergoing laparoscopic radical prostatectomy (LRP).

Main Methods:

• A retrospective analysis of 600 patients undergoing LRP between March 2000 and January 2006.
• Patients were categorized into two groups: those with no prior surgery (NS) and those with a history of BOS (transurethral prostatectomy or bladder neck incision).
• All patients had clinical stage T3aN0M0 prostate cancer and the procedures were performed by the same surgeon.

Main Results:

• Patients with prior BOS were older and had lower body and prostate weights.
• A higher proportion of pT3a tumors and longer catheterization duration were observed in the BOS group.
• While initial continence at 3 months was lower in the BOS group, potency rates at 24 months and long-term continence were similar between groups.

Conclusions:

• Previous bladder outlet surgery (BOS) does not adversely affect medium-term outcomes following laparoscopic radical prostatectomy (LRP).
• Potency and continence rates are comparable in the medium term, irrespective of prior BOS history.