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

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, Group 3: >76 g). Erectile function and continence were evaluated at 3, 6, 9, and 12 months postoperative. 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 prostate-specific 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. The 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 the impact on oncological outcomes.