Prostatic Bleeding after Prostatic Biopsy Effects Oncological Outcomes with Laparoscopic Radical Prostatectomy

Area of Science:

• Urology
• Surgical Oncology
• Medical Imaging

Background:

• Adhesion of Denonvilliers' fascia is associated with prostatic bleeding post-biopsy.
• Prostatic bleeding after biopsies requires examination of its magnitude, frequency, and oncological impact.

Purpose of the Study:

• To investigate the relationship between prostatic bleeding after biopsies and oncological outcomes.
• To analyze the impact of prostatic bleeding on surgical results such as positive surgical margin and biochemical recurrence.

Main Methods:

• A cohort of 285 patients undergoing MRI and laparoscopic radical prostatectomy was analyzed.
• Patients were divided into groups with or without prostatic bleeding.
• A propensity score model was used to adjust for patient and hospital characteristics.

Main Results:

• Prostatic bleeding was significantly associated with positive surgical margin (PSM) and biochemical recurrence (BCR).
• Patients with prostatic bleeding had higher rates of PSM (4.30 OR) and BCR (2.48 OR) in a propensity-matched cohort.
• Kaplan-Meier analysis indicated improved biochemical recurrence-free survival in patients without prostatic bleeding.

Conclusions:

• Prostatic bleeding post-biopsy is a significant predictor of adverse oncological outcomes.
• Surgeons should exercise caution during excision, particularly in patients experiencing delayed prostatic bleeding.