Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy

Hsu, Elias I.; Hong, Eugene; Lepor, Herbert

doi:10.1016/s0090-4295(02)02422-6

Cited by 132 publications

(84 citation statements)

References 11 publications

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“…Another study of 2,996 patients did not find a significant association of shorter intervals with EBL, operative time, positive surgical margins, postoperative erectile dysfunction, or urinary incontinence (12). All patients in the present analysis had retropubic RP, and these findings are applicable to RP performed via the robotic or laparoscopic approach (13,14). In addition, because many treatment options are available for clinically localized prostate cancer, significant periods are often required before finalizing the treatment choice decision.…”

Section: Discussionmentioning

confidence: 51%

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

Choi

Kang

et al. 2009

Cancer Res Treat

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Section: Discussionmentioning

confidence: 51%

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

Choi

Kang

et al. 2009

Cancer Res Treat

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“…This belief is supported by the current findings, as well as earlier studies, which found larger prostates were associated with significantly higher EBL and greater transfusion risk. 6,10 Indeed, in this study, prostate weight was the greatest contributor to blood loss. The mean-adjusted EBL for the smallest prostates (o20 g) was only 721 ml, compared to 1326 ml for the largest prostates (X100 g), an almost twofold increase.…”

Section: Discussionmentioning

confidence: 57%

“…Other contemporary series have documented somewhat lower values, with mean EBL ranging from 603 to 953 ml. 5,6,17 However, patients in these series were enrolled after 1993-a more contemporary population than the SEARCH database. Additionally, patients in these series underwent their procedures at university-based centers, rather than the VA hospitals of SEARCH.…”

Section: Discussionmentioning

confidence: 99%

Preoperative predictors of blood loss at the time of radical prostatectomy: results from the SEARCH database

Lloyd

Bañez

Aronson

et al. 2009

Prostate Cancer Prostatic Dis

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The literature contains conflicting data on preoperative predictors of estimated blood loss (EBL) at radical retropubic prostatectomy (RRP). We sought to examine preoperative predictors of EBL at the time of RRP among patients from the SEARCH database to lend clarity to this issue. A total of 1154 patients were identified in the SEARCH database who underwent RRP between 1988 and 2008 and had EBL data available. We examined multiple preoperative factors for their ability to predict EBL using multivariate linear regression analysis. Median EBL was 900 ml (s.d. 1032). The 25th and 75th percentile for EBL were 600 and 1500 ml, respectively. EBL increased significantly with increasing body mass index (BMI) and increasing prostate size and decreased with more recent year of RRP (all Po0.001). The mean-adjusted EBL in normal-weight men (BMIo25 kg/m 2 ) was 807 ml compared to 1067 ml among severely obese men (BMIX35 kg/m 2 ). Predicted EBL for men with the smallest prostates (o20 g) was 721 ml, compared to 1326 ml for men with prostates X100 g. Finally, statistically significant differences between centers were observed, with mean-adjusted EBL ranging from 844 to 1094 ml. Both BMI and prostate size are predictors of increased EBL. Prostate size is of particular note, as a nearly twofold increased EBL was seen from the smallest (o20 g) to the largest prostates (X100 g). Over time, average EBL significantly decreased. Finally, significant differences in EBL were observed between centers. Patients with multiple risk factors should be forewarned they are at increased risk for higher EBL, which may translate into a greater need for blood transfusion.

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“…In various studies the impact of prostate volume on prostate surgery has been investigated, and larger prostate volume has been held responsible for prolonged operative times, and increased amount of bleeding. [6][7][8] Min et al [9] reported that higher rates of surgical margin positivity were seen in patients with lower prostate volume who had undergone retropubic radical prostatectomies (RRP). However, they published their outcomes indicating that prostate volume less than 40 g is an independent risk factor for biochemical recurrence at 5. month of the follow-up period Chang et al [10] allocated 400 patients on whom they had performed laparoscopic radical prostatectomy (LRP) into two groups based on their prostate volumes.…”

Section: Discussionmentioning

confidence: 99%

The effect of prostate weight on the outcomes of robot-assisted radical prostatectomy

Boylu

Turan

Başataç

et al. 2013

Turkish Journal of Urology

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Objective: The effect of prostate volume on the surgical, functional, and oncological outcomes of robot assisted radical prostatectomy (RARP) was evaluated. Material and methods:A total of 180 patients who underwent RARP and had at least a 1-year follow-up were included. The patients were divided into 3 groups based on prostate weight (Group 1: <45 g, Group 2: 45-75 g, and Group 3: >76 g). Erectile function and continence were evaluated at 3, 6, 9, and 12 months postoperatively. The International Index of Erectile Dysfunction (IIEF) score and daily pad usage were evaluated as indicators of erectile function and continence, respectively. The measurement of two prostatespecific antigen (PSA) values over 0.2 ng/mL was considered biochemical disease recurrence. Results:Patients with larger prostates were older and had a longer operative time and higher PSA level compared with patients with smaller prostates (p<0.05). The positive surgical margin rate was higher in patients with smaller prostates (p=0.06). However, patients with a prostate weight <45 g had higher IIEF scores at 3 and 6 months. IIEF scores were similar at the end of the 1-year follow-up period. Pad usage and time to continence were higher in patients with larger prostates (p>0.05). Conclusion:Although prostate weight affected the surgical outcomes of RARP, the functional and oncological outcomes were similar among all patients. Long-term follow-up is needed to determine their impact on oncological outcomes.

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Influence of body weight and prostate volume on intraoperative, perioperative, and postoperative outcomes after radical retropubic prostatectomy

Cited by 132 publications

References 11 publications

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

Biopsy Related Prostate Status Does Not Affect on the Clinicopathological Outcome of Robotic Assisted Laparoscopic Radical Prostatectomy

Preoperative predictors of blood loss at the time of radical prostatectomy: results from the SEARCH database

The effect of prostate weight on the outcomes of robot-assisted radical prostatectomy

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