Total prostatectomy within 6 weeks of a prostate biopsy: is it safe?

Abstract

Purpose: Many urologists recommend a six-week time interval between a prostate biopsy and a total prostatectomy (TP) to allow the biopsy induced inflammation to subside. Our aim was to assess whether the time interval between prostate biopsy and TP has an impact on the surgical outcome. Materials and Methods: A retrospective analysis was performed on data from patients who underwent a TP by a single surgeon from 1992 to 2008. The patients were divided into two groups according to the time interval between biopsy and TP, Group 1 ≤ 6 weeks and Group 2 > 6 weeks. Relevant perioperative variables and outcome were analyzed. Results: 923 patients were included. There was a significant difference between the two groups in the surgeons' ability to perform a bilateral nerve sparing procedure. Those who had a TP within six weeks of the biopsy were less likely to have a bilateral nerve sparing procedure. No significant difference was noted in the other variables, which included Gleason score, surgical margin status, estimated blood loss, post-operative infection, incontinence, erectile function, and biochemical recurrence. Conclusions: TP can be safely performed without any increase in complications within 6 weeks of a prostate biopsy. However, a TP within six weeks of a biopsy significantly reduced the surgeon's perception of whether a bilateral nerve sparing procedure was performed.

Interval from Prostate Biopsy to Radical Prostatectomy Does Not Affect Immediate Operative Outcomes for Open or Minimally Invasive Approach

“…We recorded demographic and clinicopathologic variables and compared these variables between subgroups of biopsy-to-surgery interval <4 weeks and ≥4 weeks for each group. To assess the immediate operative outcome, we set the primary endpoint as positive surgical margin status and the secondary endpoints as operative time and estimated blood loss, as in most of the previous studies ( 4 , 5 , 6 , 7 , 8 , 9 ).…”

“…Traditionally, urologists tend to recommend an interval of at least 4 weeks after prostate biopsy before radical prostatectomy to allow biopsy-induced inflammation or hematoma to subside ( 3 ). However, studies have shown that early radical prostatectomy does not affect immediate operative outcomes such as operative time, estimated blood loss, and positive surgical margin status for either conventional radical retropubic prostatectomy ( 4 , 5 , 6 ) or robot-assisted laparoscopic radical prostatectomy ( 7 , 8 , 9 ). Nonetheless, to our knowledge there are no studies evaluating this subject with respect to the surgical approach.…”

Short interval of biopsy to robotic-assisted laparoscopic radical prostatectomy does not render any adverse effects on the perioperative outcomes

“…In fact, most studies supported the opinion that the interval between the biopsy and surgery was not related to the perioperative outcomes even in open prostatectomy. [ 21 – 23 ] Furthermore, undergoing the prostatectomy as soon as possible may be beneficial for patients in high risk group (higher PSA level or Gleason scores). [ 24 ]…”

Can radical prostatectomy shortly after prostate biopsy affect intra-operative and postoperative outcomes?

“…A fair number of studies have been carried out on surgical outcomes compared according to the interval from prostate biopsy to surgery. 7 8 9 Lee et al . 5 showed, on a series of 169 patients, no significant correlation in perioperative outcomes and complications with the interval after biopsy.…”