Patients with Marked Prostatomegaly and Clinically Significant Prostate Cancer Have Inferior Perioperative Outcomes...

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is standard for localized prostate cancer.
• Patients with marked prostatomegaly (>100g) may face worse surgical outcomes.
• Limited multi-surgeon data exists on RARP complications in this specific patient group.

Purpose of the Study:

• To compare perioperative complications and oncologic outcomes in RARP patients with marked prostatomegaly versus average-sized glands.
• To identify specific risks associated with RARP in men with large prostates.
• To inform preoperative counseling and surgical planning.

Main Methods:

• Retrospective cohort study of 2030 RARP patients at a tertiary academic center.
• Comparison of perioperative complications and oncologic outcomes between groups (prostate volume >100g vs. <100g).
• Logistic regression analysis to determine odds ratios for complications and outcomes.

Main Results:

• Marked prostatomegaly was associated with 60% higher odds of perioperative complications.
• Patients with large prostates were over twice as likely to have ED visits or hospital readmissions.
• Non-nerve-sparing or unilateral nerve-sparing procedures were 25% more likely in the marked prostatomegaly group, though oncologic outcomes were comparable.

Conclusions:

• Marked prostatomegaly increases perioperative complications, emergency visits, and readmissions after RARP.
• While nerve-sparing techniques were less frequent, oncologic results were similar between groups.
• Prospective, multicenter studies are needed to confirm these findings and refine patient counseling.