Robotic assisted laparoscopic radical prostatectomy following transrectal compared to transperineal prostate biopsy: surgical, oncological and functional outcomes.

30 Apr 2019

Abstract BACKGROUND To assess if transperineal prostate (TP) biopsy affects the outcome of robotic-assisted laparoscopic prostatectomy (RALP), with particular reference to peri-operative complications, oncological results and functional outcomes in the early post operative setting. METHODS We identified 61 men who had undergone RALP after TP biopsies, from June 2012 to June 2014 and a control group of 120 men who had undergone RALP after conventional TRUS biopsy in the same period. Data was compared from the pre-operative biopsy, peri and post-operative period, procedural outcomes including histological, oncological and functional outcomes between the groups. RESULTS The groups had comparable demographics, with matched median ages and PSA levels. There was a higher incidence of Gleason 6 disease detected in the TRUS group (p = 0.01). Mean operative time (146 minutes TRUS vs. 158 minutes TP, p = 0.133), blood loss (250mls TRUS vs. 288mls TP, p=0.462) and intraoperative complications were not significantly different between groups. Median length of stay (1 day) and median catheter duration (7 days) were identical in both cohorts. PSA failure rate at 6 months was similar (11.7% TRUS vs. 9.8% TP, p=0.904). There were no differences in functional outcomes (potency or continence) between groups at 6 months follow up. CONCLUSIONS RALP is safe after TP biopsy with no adverse impact on oncological or short-term functional outcomes.