Effect of large prostate volume on perioperative, oncological and functional outcomes after robotic radical prostatectomy: A retrospective clinical study

Objective: In this study, we aimed to evaluate the effect of large prostate volume on surgical, oncological and functional outcomes in prostate cancer patients who underwent Robot-assisted radical prostatectomy (RARP). Material and Methods: In this study, patients who underwent RARP due to prostate cancer by a single surgeon were divided into two groups as large prostate volume over 75 cc (Group-1) and prostate volume less than 75 cc (Group-2), and these two groups were compared retrospectively. Patients who were followed up for 12 months were assessed. Results: There was no significant difference between the two groups in terms of age, preoperative PSA level, clinical stage distributions, Gleason score, D’Amico risk classification, preoperative potency and continence assessment (p>0.05). The operative time was 169.9 ± 62.5 minutes and 145.6 ± 56.1 minutes in Groups 1 and 2, respectively, and was significantly higher in Group 1 (p= 0.02). Bladder neck reconstruction was performed in 17 (35%) and 2 (3%) patients in Groups 1 and 2, respectively, and it was statistically significantly higher in Group-1 (p=0.001). After removal of the urethral catheter in Group 1 and Group 2, full continence and potency rates were similar during the 1-year follow-up (p >0.05). Biochemical recurrence rates at 6 months and 1 year were similar in Group 1 and Group 2 (p >0.05). Conclusion: In prostate cancer patients with large prostate volume, RARP results in longer operative time and bladder neck reconstruction may be required.. However, in operations performed by experienced surgeons, large prostate volume does not have a negative effect on surgical, functional and oncological outcomes. Keywords: robotic surgical procedures, prostatectomy, prostate, organ size