Does the Presence of Median Lobe Affect Outcomes of Robot-Assisted Laparoscopic Radical Prostatectomy?

    Authors

    R. F. Coelho; S. Chauhan; G. B. Guglielmetti; M. A. Orvieto; A. Sivaraman; K. J. Palmer; B. Rocco; G. Coughlin; R. El Hassan; M. F. Dall'Oglio;V. R. Patel

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    Abbreviated Journal Title

    J. Endourol.

    Keywords

    BLADDER NECK PRESERVATION; SURGICAL LEARNING-CURVE; RETROPUBIC; PROSTATECTOMY; URINARY CONTINENCE; IMPACT; CANCER; Urology & Nephrology

    Abstract

    Purpose: To determine whether the presence of median lobe (ML) affects perioperative outcomes, positive surgical margin (PSM) rates, and recovery of urinary continence after robot-assisted radical prostatectomy (RARP). Patients and Methods: We analyzed 1693 consecutive patients undergoing RARP performed by a single surgeon. Patients were analyzed in two groups based on the presence or not of a ML identified during RARP. Perioperative outcomes, PSM rates, and recovery of urinary continence were compared between the groups. Continence was assessed using validated questionnaires, and it was defined as the use of "no pads" postoperatively. Results: A ML was identified in 323 (19%) patients. Both groups had similar estimated blood loss, length of hospital stay, pathologic stage, complication rates, anastomotic leakage rates, overall PSM rates, and PSM rate at the bladder neck. The median overall operative time was slightly greater in patients with ML (80 vs 75 min, P < 0.001); however, there was no difference in the operative time when stratifying this result by prostate weight. Continence rates were also similar between patients with and without ML at 1 week (27.8% vs 27%, P = 0.870), 4 weeks (42.3% vs 48%, P = 0.136), 12 weeks (82.5% vs 86.8%, P = 0.107), and 24 weeks (91.5% vs 94.1%, P = 0.183) after catheter removal. Finally, the median time to recovery of continence was similar between the groups (median: 5 wks, 95% confidence interval [CI]: 4.41-5.59 vs median: 5 wks, CI 4.66-5.34; log rank test, P = 0.113). Conclusion: The presence of a ML does not affect outcomes of RARP performed by an experienced surgeon.

    Journal Title

    Journal of Endourology

    Volume

    26

    Issue/Number

    3

    Publication Date

    1-1-2012

    Document Type

    Article

    Language

    English

    First Page

    264

    Last Page

    270

    WOS Identifier

    WOS:000301143400013

    ISSN

    0892-7790

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