Top

Published in:

05-04-2023 | Prostate Cancer | Review

Does previous transurethral resection of the prostate negatively influence subsequent robotic-assisted radical prostatectomy in men diagnosed with prostate cancer? A systematic review and meta-analysis

Authors: Li Gu, Yijian Li, Xurui Li, Wentao Liu

Published in: Journal of Robotic Surgery | Issue 4/2023

Abstract

It is not uncommon to incidentally discover prostate cancer during the transurethral resection of the prostate (TURP) for the treatment of benign prostatic hyperplasia and necessitate a subsequent robotic-assisted radical prostatectomy (RARP). The study aims to evaluate whether TURP have negative influence on subsequent RARP. Through a literature search using MEDLINE, EMBASE and the Cochrane Library, 10 studies with 683 patients who underwent RARP after previous TURP and 4039 patients who underwent RARP only were identified for the purposes of the meta-analysis. Compared to standard RARP, RARP after TURP was related to longer operative time (WMD: 29.1 min, 95% CI: 13.3–44.8, P < 0.001), more blood loss (WMD: 49.3 ml, 95% CI: 8.8–89.7, P = 0.02), longer time to catheter removal (WMD: 0.93 days, 95% CI: 0.41–1.44, P < 0.001), higher rates of overall (RR: 1.45, 95% CI: 1.08–1.95, P = 0.01) and major complications (RR: 3.67, 95% Cl: 1.63–8.24, P = 0.002), frequently demand for bladder neck reconstruction (RR: 5.46, 95% CI: 3.15–9.47, P < 0.001) and lower succeed in nerve sparing (RR: 0.73, 95% CI: 0.62–0.87, P < 0.001). In terms of quality of life, there are worse recovery of urinary continence (RR of incontinence rate: RR: 1.24, 95% CI: 1.02–1.52, P = 0.03) and potency (RR: 0.8, 95% CI: 0.73–0.89, P < 0.001) at 1 year in RARP with previous TURP. In addition, the RARP with previous TURP had greater percentage positive margins (RR: 1.24, 95% CI: 1.02–1.52, P = 0.03), while there is no difference in length of stay and biochemical recurrence rate at 1 year. RARP is feasible but challenging after TURP. It significantly increases the difficulty of operation and compromises surgical, functional and oncological outcomes. It is important for urologists and patients to be aware of the negative impact of TURP on subsequent RARP and establish treatment strategies to lessen the adverse effects.

Available only for authorised users

Siegel RL, Miller KD, Fuchs HE, Jemal A (2022) Cancer statistics, 2022. CA Cancer J Clin 72:7–33. https://doi.org/10.3322/caac.21708CrossRefPubMed

Gray PJ, Lin CC, Cooperberg MR, Jemal A, Efstathiou JA (2017) Temporal trends and the impact of race, insurance, and socioeconomic status in the management of localized prostate cancer. Eur Urol 71:729–737. https://doi.org/10.1016/j.eururo.2016.08.047CrossRefPubMed

Gupta NP, Singh P, Nayyar R (2011) Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate. BJU Int 108:1501–1505. https://doi.org/10.1111/j.1464-410X.2011.10113.xCrossRefPubMed

Hung CF, Yang CK, Ou YC (2014) Robotic assisted laparoscopic radical prostatectomy following transurethral resection of the prostate: perioperative, oncologic and functional outcomes. Prostate Int 2:82–89. https://doi.org/10.12954/PI.14046CrossRefPubMedPubMedCentral

Su YK et al (2015) Does previous transurethral prostate surgery affect oncologic and continence outcomes after RARP? J Robot Surg 9:291–297. https://doi.org/10.1007/s11701-015-0529-9CrossRefPubMed

Garg H, Seth A, Kumar R (2022) Impact of previous transurethral resection of prostate on robot-assisted radical prostatectomy: a matched cohort analysis. J Robot Surg 16:1123–1131. https://doi.org/10.1007/s11701-021-01348-8CrossRefPubMed

Tugcu V et al (2015) Robot-assisted radical prostatectomy after previous prostate surgery. JSLS 19:e2015 00080. https://doi.org/10.4293/JSLS.2015.00080CrossRefPubMedPubMedCentral

Gellhaus PT et al (2015) Robot-assisted radical prostatectomy in patients with a history of holmium laser enucleation of the prostate: feasibility and evaluation of initial outcomes. J Endourol 29:764–769. https://doi.org/10.1089/end.2014.0767CrossRefPubMed

Zugor V, Labanaris AP, Porres D, Witt JH (2012) Surgical, oncologic, and short-term functional outcomes in patients undergoing robot-assisted prostatectomy after previous transurethral resection of the prostate. J Endourol 26:515–519. https://doi.org/10.1089/end.2011.0205CrossRefPubMed

10.

Shamseer L et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647. https://doi.org/10.1136/bmj.g7647CrossRefPubMed

11.

Wan X, Wang W, Liu J, Tong T (2014) Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 14:135. https://doi.org/10.1186/1471-2288-14-135CrossRefPubMedPubMedCentral

12.

Downs SH, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Comm Health 52:377–384. https://doi.org/10.1136/jech.52.6.377CrossRef

13.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188. https://doi.org/10.1016/0197-2456(86)90046-2CrossRefPubMed

14.

Hampton L, Nelson RA, Satterthwaite R, Wilson T, Crocitto L (2008) Patients with prior TURP undergoing robot-assisted laparoscopic radical prostatectomy have higher positive surgical margin rates. J Robot Surg 2:213–216. https://doi.org/10.1007/s11701-008-0121-7CrossRefPubMed

15.

Abedali ZA et al (2020) Robot-assisted radical prostatectomy in patients with a history of holmium laser enucleation of the prostate: the Indiana university experience. J Endourol 34:163–168. https://doi.org/10.1089/end.2019.0436CrossRefPubMed

16.

Leyh-Bannurah SR et al (2021) Perioperative and postoperative outcomes of robot-assisted radical prostatectomy in prostate cancer patients with prior transurethral subvesical deobstruction: results of a high-volume center. J Urol 206:308–318. https://doi.org/10.1097/JU.0000000000001776CrossRefPubMed

17.

Merrill RM, Wiggins CL (2002) Incidental detection of population-based prostate cancer incidence rates through transurethral resection of the prostate. In: Urologic oncology: seminars and original investigations. Elsevier vol 7, no 5, pp 213–219

18.

Colombo R et al (2006) Radical prostatectomy after previous prostate surgery: clinical and functional outcomes. J Urol 176:2459–2463. https://doi.org/10.1016/j.juro.2006.07.140CrossRefPubMed

19.

Rassweiler J, Teber D, Kuntz R, Hofmann R (2006) Complications of transurethral resection of the prostate (TURP)–incidence, management, and prevention. Eur Urol 50:969–979. https://doi.org/10.1016/j.eururo.2005.12.042CrossRefPubMed

20.

Wolin KY, Luly J, Sutcliffe S, Andriole GL, Kibel AS (2010) Risk of urinary incontinence following prostatectomy: the role of physical activity and obesity. J Urol 183:629–633CrossRefPubMed

21.

Sandhu JS et al (2019) Incontinence after prostate treatment: AUA/SUFU guideline. J Urol 202:369–378CrossRefPubMed

22.

Cooperberg MR, Odisho AY, Carroll PR (2012) Outcomes for radical prostatectomy: is it the singer, the song, or both? J Clin Oncol Off J Am Soc Clin Oncol 30:476–478CrossRef

23.

Checcucci E et al (2021) The importance of anatomical reconstruction for continence recovery after robot assisted radical prostatectomy: a systematic review and pooled analysis from referral centers. Minerva Urol Nephrol 73:165–177. https://doi.org/10.23736/S2724-6051.20.04146-6CrossRefPubMed

24.

Mungovan SF et al (2021) Preoperative exercise interventions to optimize continence outcomes following radical prostatectomy. Nat Rev Urol 18:259–281. https://doi.org/10.1038/s41585-021-00445-5CrossRefPubMedPubMedCentral

25.

Fernandez RA et al (2015) Improvement of continence rate with pelvic floor muscle training post-prostatectomy: a meta-analysis of randomized controlled trials. Urol Int 94:125–132. https://doi.org/10.1159/000368618CrossRefPubMed

26.

Yossepowitch O et al (2009) Positive surgical margins in radical prostatectomy: outlining the problem and its long-term consequences. Eur Urol 55:87–99. https://doi.org/10.1016/j.eururo.2008.09.051CrossRefPubMed

27.

Mottet N et al (2017) EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71:618–629. https://doi.org/10.1016/j.eururo.2016.08.003CrossRefPubMed

28.

Anand A, Gupta S (2021) Prostate-specific antigen increase after urethral catheterisation: fact or myth. Afr J Urol 27:1–3CrossRef

29.

Johnson DC et al (2019) Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging. Eur Urol 75:712–720. https://doi.org/10.1016/j.eururo.2018.11.031CrossRefPubMed

30.

Wang C et al (2022) Combination of PI-RADS score and PSAD can improve the diagnostic accuracy of prostate cancer and reduce unnecessary prostate biopsies. Front Oncol 12:1024204. https://doi.org/10.3389/fonc.2022.1024204CrossRefPubMedPubMedCentral

31.

Jiao J et al (2021) Establishment and prospective validation of an SUV(max) cutoff value to discriminate clinically significant prostate cancer from benign prostate diseases in patients with suspected prostate cancer by (68)Ga-PSMA PET/CT: a real-world study. Theranostics 11:8396–8411. https://doi.org/10.7150/thno.58140CrossRefPubMedPubMedCentral

Title: Does previous transurethral resection of the prostate negatively influence subsequent robotic-assisted radical prostatectomy in men diagnosed with prostate cancer? A systematic review and meta-analysis
Authors: Li Gu
Yijian Li
Xurui Li
Wentao Liu
Publication date: 05-04-2023
Publisher: Springer London
Keywords: Prostate Cancer
Prostate Cancer
Benign Prostatic Hypertrophy
Prostatectomy
Benign Prostatic Hypertrophy
Transurethral Prostate Resection
Prostatectomy
Published in: Journal of Robotic Surgery / Issue 4/2023
Print ISSN: 1863-2483
Electronic ISSN: 1863-2491
DOI: https://doi.org/10.1007/s11701-023-01588-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does previous transurethral resection of the prostate negatively influence subsequent robotic-assisted radical prostatectomy in men diagnosed with prostate cancer? A systematic review and meta-analysis

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2023

Robotic transaxillary thyroidectomy: time to expand indications?

Learning curves and perioperative outcomes of single-incision robotic sacrocolpopexy on two different da Vinci® surgical systems

Surgeon administered transversus abdominis plane block: anatomic principles and technique

Technical and anatomic considerations of skin flap elevation in bilateral axillo-breast insufflation robotic-assisted neck dissection

Perioperative, functional, and oncologic outcomes in patients undergoing robot-assisted radical prostatectomy previous transurethral resection of prostate: a systematic review and meta-analysis of comparative trials

Video gaming improves robotic surgery simulator success: a multi-clinic study on robotic skills