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Minerva Urologica e Nefrologica 2017 February;69(1):85-92

DOI: 10.23736/S0393-2249.16.02759-4


language: English

Robotic assisted laparoscopic radical prostatectomy following transrectal compared to transperineal prostate biopsy: surgical, oncological and functional outcomes

Karan WADHWA 1, 2, Giulio PATRUNO 2, Andrew PATTERSON 3, Tristan BARRETT 1, 3, Chandni DALIA 2, Brendan C. KOO 3, Ferdia A. GALLAGHER 3, Eva SERRAO 3, Anne WARREN 4, Vincent GNANAPRAGASAM 1, 2, Nimish SHAH 1, 2, Andrew DOBLE 1, 2, Christof KASTNER 1, 2

1 CamPARI Clinic, Addenbrookes Hospital and University of Cambridge, Cambridge, UK; 2 Department of Urology, Addenbrooke’s Hospital, Cambridge, UK; 3 Department of Radiology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK; 4 Department of Histopathology, Addenbrooke’s Hospital and University of Cambridge, Cambridge, UK


BACKGROUND: To assess if transperineal prostate (TP) biopsy affects th e outcome of robotic-assisted laparoscopic prostatectomy (RALP), with particular reference to perioperative complications, oncological results and functional outcomes in the early postoperative setting.
METHODS: We identified 61 men who had undergone RALP after TP biopsies, from June 2012 to June 2014 and a control group of 120 men who had undergone RALP after conventional TRUS biopsy in the same period. Data was compared from the pre-operative biopsy, peri- and postoperative period, procedural outcomes including histological, oncological and functional outcomes between the groups.
RESULTS: The groups had comparable demographics, with matched median ages and PSA levels. There was a higher incidence of Gleason 6 disease detected in the TRUS group (P=0.01). Mean operative time (146 minutes TRUS vs. 158 minutes TP, P=0.133), blood loss (250 mL TRUS vs. 288 mL TP, P=0.462) and intraoperative complications were not significantly different between groups. Median length of stay (1 day) and median catheter duration (7 days) were identical in both cohorts. PSA failure rate at 6 months was similar (11.7% TRUS vs. 9.8% TP, P=0.904). There were no differences in functional outcomes (potency or continence) between groups at 6 month s follow-up.
CONCLUSIONS: RALP is safe after TP biopsy with no adverse impact on oncological or short-term functional outcomes.

KEY WORDS: Transperineal biopsy - Robot assisted radical prostatectomy - Surgical outcomes - MRI-fusion biopsy

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