J Boczko, S Capello, M Mathe, E Erturk, H Patel, JV Joseph
University of Rochester Medical Center, Rochester, NY, USA

Method: Data from 361 consecutive RAPs by a single surgeon was collected. Men <60 years and > 60 years were compared in the following parameters: body mass index (BMI), total operating time, estimated blood loss, prostate specific antigen (PSA), specimen weight, pathologic stage and Gleason score, operative and postoperative complications, surgical margin status, and 6 month continence.

Result: The younger patients had a statistically significant (p<.05) lower specimen weight (49 vs. 57 grams) and pathologic Gleason score (6 vs. 7) than the older patients. No significant difference was noted between the two groups in operative time (215 vs. 221 min), blood loss (192 vs. 173 ml), PSA, BMI, positive margin rate (15% vs. 14%) urinary tract infection (1.8% vs. 2% of men), urinary retention post catheter removal (1.2% vs. 2%), and bladder neck contractures
(3.6% vs. 1.5%). 98% of men <60 were fully continent at 6 months compared to 92.6% of men > 60 (P<.05).

Conclusion: Younger patients undergoing robot-assisted prostatectomy have a more rapid return to full continence status. However, although not statistically significant, younger patients are at an increased incidence of bladder neck contracture. One cause for this increased risk could be the significantly smaller prostates found in these younger patients. In order to alleviate this problem, extreme care should be used to minimize cautery use at the bladder neck and preserve its collateral flow, especially when operating on smaller prostates.

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