Surgical and Functional Outcomes of Radical Retropubic Prostatectomy After Biopsy Related Acute Prostatitis
To compare the morbidity and functional results after radical retropubic prostatectomy with and without previous transrectal prostate biopsy related acute prostatitis history.
From May 2010 to June 2016, data available 320 patients underwent radical retropubic prostatectomy, of whom 23 (7.2%) had previous transrectal prostate biopsy related acute prostatitis history were included for this study. The perioperative and postoperative data were compared between group 1 (with previous prostatitis) and group 2 (without previous prostatitis). The functional results were assessed by self-administered questionnaires at 12 months after surgery.
Table 1 lists the baseline characteristics of the 320 included patients. In group 1, the operative time, hospitalization and bladder catheterization time was statistically increased by 40 minutes, 1.9 days, and 2.5 days, respectively (p<0.001, p<0.001, p=0.02) (Table 2). The positive margin rate was not signficantly different between the two groups (p=0.64) (Table 2). The number of complications with Clavien > 2 (Urirnary fistula, sepsis, lymphocele, cardiopulmonary resuscitation (CPR), rectal injury) occurred in 26 % of group 1 and 12% of group 2 (p=0.02) (Table 2). The continence rate was 88.9% in group 1 and 94.8% in group 2 respectively, 12 months after the surgery (p =0.57), and the potency rate with neurovascular bundle preservation was 63.1% and 68.9% respectively, (p=0.61) (Table 2). However, neurovascular bundle preservation was performed after previous prostatitis in only 56.5% of group 1 vs 78.9% in group 2 (p=0.02) (Table 2).
Radical retropubic prostatectomy can be performed in patients with prostatitis history without compromising the oncologic results. However, patients should be informed that the procedure is associated with worse intraoperative and postoperative outcomes. Although the urinary continence rate was not affected by previous prostatitis, neurovascular bundle preservation is technically more difficult.