WCE 2017: An Evaluation of Functional Outcomes after Robot-Assisted Radical Prostatectomy in Patients with Large Prostates (≥ 60g)

Vancouver, Canada (UroToday.com) Robot assisted radical prostatectomy (RARP) is considered the gold standard for treatment of prostate cancer. In some cases enlargement of the prostate occurs due to the cancerous tissues among other clinical variables. This increase in prostate size can cause patients to experience lower urinary tract symptoms (LUTS). In this study Dr. Law and colleagues aim to evaluate the effects of RARP on the functional outcomes of men whose prostate was larger than 60 grams.

For this study the Dr. Law and his team retrospectively analyzed 75 patients, whose prostates weighed more than 60 grams, from July 2004 to April 2013. Baseline and post-RARP functional outcomes were accessed using theInternational Prostate Symptom Score (IPSS), a quality of life questionnaire, mean peak flow rates (Qmax), and PVR values. The study team evaluated their data using standard t-test and chi-square tests. The study team stratified these men based on prostate weight into three groups: >60g and <75g, >75g and <90g, and >90g. Dr. Law also mentioned during his presentation that, in place of the standard figure 8 stitch, a square base suture was used during the procedure for better anchoring during the posterior wall dissection. It is of note to mention that only 35% of patients who underwent RARP received any form of nerve sparring.

The study team found that in their analysis of 75 consecutive patients, there was no correlation between patient demographics and prostate size. They also found that there was no difference in hospitalization time, total operative time, and blood loss between the three groups. Dr. Law reported that there was also no mortality or conversion to open surgery due to prostate size. During his presentation, Dr. Law mentioned that 88.9% of patients had full return to continence at 1 year regardless of prostate weight. Overall improvement in IPSS and QoL score was observed when comparing the baseline to 6 and 12 months, however no statistical significance was reached.

Overall Dr. Law and his team showed that RARP is still a suggestable and safe method for treatment of prostate cancer in men with large prostates.

Presented by: Yu Xi Terence Law, BSc(Hons), MBBS, MRCS

Authors: Yu Xi Terence Law, Ming Shan Darren Tan, Jing Zeng Du, Hong Hong Huang, Sun Sien Henry Ho
Affiliation: Department of Urology, Singapore General Hospital Singapore, Singapore, Yong Loo Lin School of Medicine, National University of Singapore,

Written by: Anthony Warner (AS), research intern, University of California, Irvine at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.