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Minerva Urologica e Nefrologica 2019 Oct 10

DOI: 10.23736/S0393-2249.19.03526-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Laparoscopic simple prostatectomy: complications and functional results after 5 years of follow-up

Matteo MANFREDI 1 , Cristian FIORI 1, Dario PERETTI 1, Federico PIRAMIDE 1, Enrico CHECCUCCI 1, Diletta GARROU 1, Daniele AMPARORE 1, Stefano DE LUCA 1, Michele DI DIO 2, Roberto M. SCARPA 3, Francesco PORPIGLIA 1

1 Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy; 2 Division of Urology, Department of Surgery, SS Annunziata Hospital, Cosenza, Italy; 3 Department of Urology, University of Rome, Campus Bio-Medico, Rome, Italy


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BACKGROUND: The aim was to investigate complications and functional results in a cohort of patients who underwent extraperitoneoscopic transcapsular laparoscopic simple prostatectomy (LSP) for large prostate adenomas with a minimum follow-up of 5 years.
METHODS: We retrospectively reviewed data obtained from our prospectively maintained database of patients treated with LSP at our institution between January 2004 and June 2012, with at least 5 years of reported follow-up data. Demographics, perioperative results, early and late complications, and functional results were evaluated. The various impacts of the independent variables on the development of complications was evaluated performing logistic regression models. Follow-up was planned at 1, 3, 6 and 12 months, then yearly up to a minimum of 5 years.
RESULTS: One-hundred patients were included in our analysis. Median follow-up was 135 (IQR 24) months (11 years and 3 months). Grade III complications were recorded in 2 cases. Five cases of late postoperative complications were recorded. Logistic regression models showed a statistically significant correlation between the adenoma volume and the risk of developing early post-operative complications (OR 1.014). International Prostate Symptom Score (I-PSS), I-PSS quality of life (QoL) index, and maximum urine flow (Qmax) significantly improved when comparing preoperative and postoperative results. No significant differences were recorded in the I-PSS and I-PSS QoL index during follow-up. A low but significant worsening in Qmax was observed starting the 48th month after surgery.
CONCLUSIONS: The present findings confirm that LSP carries a low rate of early and late complications, and it offers good functional outcomes at 5 years.


KEY WORDS: Prostate; Prostatic hyperplasia; Prostatectomy; Laparoscopy; Complications

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