[OP-054]

Does presence of a median lobe affect complications, oncological outcomes and urinary continence followingrobotic-assisted radical prostatectomy?

¹Department of Urology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
²Department of Urology, Ankara Yildirim Beyazit University School of Medicine, Ankara, Turkey

OBJECTIVES:
To evaluate if presence of median lobe (ML) affect perioperative complications, positive surgical margins (SMP), biochemical recurrence (BCR) and urinary continence (UC) following robotic-assisted radical prostatectomy (RARP).

METHODS:
Data of 924 consecutive patients who underwent RARP for prostate cancer (PCa) and who have at least 1-year follow-up were evaluated retrospectively. Group 1 (n=252) included patients with ML and Group 2 (n=672) included patients without ML. Data including age, body mass index, pathological stage and Gleason grade of PCa, total PSA, prostate volume, previous prostate surgery, SMP, operative time, intraoperative estimated blood loss, abdominal drainage removal duration, duration of urethral catheter removal and duration of hospital stay were recorded. All patients were evaluated in terms of BCR and UC during the follow-up period. Patients who were dry and used 0-1 pad/day were regarded as continent. Patients who used >1 pad/day were regarded as incontinent.

RESULTS:
Both groups were statistically similar in terms of demographics and variables about PCa. Mean prostate volume was higher in Group 1 vs. Group 2 (69±31 vs. 56±23 ml, p<0.001). Total operative time was longer in Group 1 vs. Group 2 (144±38 vs. 136±44 min, p=0.01). Biochemical recurrence, SMP, perioperative and postoperative complication rates of our population were 13.6, 14.9, 1.7 and 8.7%, respectively. There were no statistical differences in terms of perioperative complication, SMP and BCR rates between the groups (p>0.05). At the 1st month after RARP, total continence rate was statistically significant lower in Group-1 vs Group-2 (49.2% and 56.5%, p=0.03), respectively. However, there were no significant differences in terms of continence rates at 3rd month, 6th month and 1st year follow-up (fig 1).

CONCLUSION:
Due to our experience, the presence of a ML does not seem to affect perioperative complication, intraoperative blood loss, SMP and BCR following RARP. However, the presence of a ML seems to be a disadvantage in gaining early UC following RARP.

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