ORIGINAL ARTICLE   Free access

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

DOI: 10.23736/S0393-2249.16.02759-4

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

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