Open Access

ARTICLE

Open radical prostatectomy after transurethral resection: perioperative, functional, oncologic outcomes

Charalampos Fragkoulis, Athanasios Pappas, Georgios Theocharis, Georgios Papadopoulos, Georgios Stathouros, Konstantinos Ntoumas

Department of Urology, Athens General Hospital ‘‘G. Gennimatas’’, Athens, Greece
Address correspondence to Dr. Georgios I. Papadopoulos, 1B, Kefallinias str, Maroussi, Athens, 15126 Greece

Canadian Journal of Urology 2018, 25(2), 9262-9267.

Abstract

Introduction: This study aims to evaluate whether there are differences in perioperative, functional, and oncologic outcomes following radical retropubic prostatectomy (RRP) between patients who previously underwent transurethral resection of the prostate (TURP) and those who did not. Materials and methods: A total of 35 patients diagnosed with prostate cancer (clinical stages T1a or T1b) after TURP who subsequently underwent RRP and completed at least one year of follow-up were included in group A. These patients were matched 1:1 with a control cohort (group B, n = 35) based on age, body mass index (BMI), prostate-specific antigen (PSA) levels, Gleason score, preoperative prostate volume, pathological stage, and neurovascular bundle-sparing technique. The study was retrospective and conducted between September 2011 and March 2014. Results: No significant differences were observed between the two groups in terms of functional or oncologic outcomes. However, prior prostate surgery made the surgical procedure more technically challenging. Specifically, operative time and intraoperative blood loss were significantly higher in group A, although this did not translate into increased transfusion requirements. Additionally, urinary catheter removal was delayed in group A compared to group B. Conclusion: Radical retropubic prostatectomy after prior TURP is a relatively safe procedure when performed by experienced surgeons. Previous TURP does not appear to compromise oncologic outcomes or continence rates. However, erectile function may be more adversely affected in these patients compared to those without prior prostate surgery. Due to altered anatomy, delineation of the prostate and bladder neck margins can be difficult; therefore, surgeons should be aware of the potential technical challenges associated with performing RRP in this patient population.

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