Is Radical Prostatectomy after Transurethral Resection of Prostate (TUR-P) Feasible?

Abstract

Objective: Radical prostatectomy (RP) is usually difficult after TUR-P. We assessed the possibility and studied the outcomes of RP in patients who had previously received TUR-P.
Methods: From August 2001 to April 2005, we performed 11 cases (group 2) of RP in localized cancer patients who had previously received TUR-P. The patients' operative data and outcomes of the operation were compared to another 47 cases (group 1) of RP without earlier TUR-P. The operation was performed by one surgeon using the bladder-neck sparing technique.
Results: The patients in group 2 had median operative time of 180 minutes, which was 30 minutes longer than that of group 1. Median operative blood losses were 1,100 ml and 1,000 ml in group 1 and 2, respectively. Median catheterization time was 14 days in both groups. Using Mann Whitney U-test, there were no differences among the two groups in terms of operative time, blood loss, catheterization time, hospital stay and serum PSA after the operation. The likelihood of bladder neck involvement and anastomosis stricture rate were higher in the patients who had received TUR-P with odd ratios of 3.06 and 3.15 respectively; nevertheless, these had no statistically significant difference.
Conclusion: Radical prostatectomy after TUR-P is therefore feasible; however, meticulous surgical technique is needed to prevent complication.