Prostate volume as an independent predictor of results robot-assisted prostatectomy

Background. The presence of benign hyperplastic tissue does not exclude the malignant process within one prostate gland. According to various sources, almost 40 % of patients with prostate hyperplasia can be diagnosed of prostate cancer. The large adenoma seriously complicates of radical surgery, which in this group patients, is perhaps, the only effective method of treatment. The effect of prostate volume on the main criteria the effectiveness of treatment is ambiguous. Robotic technologies, introduced into clinical practice, may have the advantages of this complicated group of patients.

Materials and methods. Study group (1^st group): 40 patients with prostate volume ≥80cm³ (9.4 %) over the period December 2014. to December 2018. were performed robot-assisted radiсal prostatectomy. The comparison group included 54 patients with prostate volume <80 см³. The average prostate volume in 1^st group was 112.2 ± 26 (80–195) cm³, in the 2^nd group – 38 ± 11.2 (17–62) cm³ (p <0.001). The 1^st group consists of older patients with a higher level of prostate-specific antigen (p <0.001).

Results. The difference in the operation time was 18.2 min, which was statistically insignificant (p >0.05). The average volume of blood loss in the 1^st group was 282.5 ± 227.5 (50–1000) ml, with 175 ± 147.2 (50–700 ml) ml in the 2^nd group (р >0,02). After 12 months, 100 % of patients in the 1^st group showed no relapse (prostate-specific antigen ≤0.2 ng/ml). The level of continental function was comparable of the monitoring group.

Conclusion. When performing robot-assisted prostatectomy increased prostate size has no effect on operating time, but significantly increases of the blood loss. The size of the prostate may serve as an important variable to predict the functional and oncological results of treatment.

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