Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP?

Area of Science:

• Urology
• Oncology
• Surgical Outcomes

Background:

• Robotic-assisted radical prostatectomy (RARP) is a common treatment for prostate cancer.
• The impact of prior transurethral resection of the prostate (TURP) on RARP outcomes is not fully understood.

Purpose of the Study:

• To evaluate the effect of previous TURP on oncologic and continence outcomes following RARP.
• To compare outcomes between patients who underwent TURP before RARP and those who did not.

Main Methods:

• Retrospective cohort study of 2693 patients undergoing RARP (2007-2014).
• Patients were divided into two groups: 49 with prior TURP and 2644 without prior TURP.
• Operative variables, urinary continence, sexual function, and quality of life (EPIC questionnaire) were assessed.

Main Results:

• Patients with prior TURP reported a significantly weaker urinary stream at 12 months post-RARP (p=0.012).
• Positive surgical margin (PSM) rates were higher in the prior TURP group (30.61% vs 20.95%), though not statistically significant (p=0.110).
• No significant differences were found in operative time, blood loss, urinary continence, social continence, or sexual function between groups.

Conclusions:

• Prior TURP may negatively impact urinary stream strength after RARP.
• Oncologic and continence outcomes after RARP appear largely unaffected by previous TURP.
• Findings can aid in counseling patients with a history of TURP prior to RARP.