The impact of prostate size in laparoscopic radical prostatectomy

Objectives: Large prostates can be challenging to remove during open or laparoscopic radical prostatectomy (LRP). Our objective was to critically analyse the impact of prostate volume in LRP. Methods: 400 cases of LRP were performed. Three hundred and fourteen patients had a small prostate (weight < 75 g) and 86 patients had a large prostate (weight >= 75 g) on final histology. The following outcomes were assessed: operative time; estimated blood loss (EBL); transfusion rate; length of hospital stay (LOS); length of catheterisation; perioperative and postoperative complications (including incontinence and erectile dysfunction); surgical margin status; and early biochemical recurrence rates. Results: Patients' age, PSA, Gleason sum and clinical stage were all similar. Larger prostates were associated with a 14 minutes longer mean operating time (p < 0.001), but fewer positive surgical margins (p = 0.01). Blood loss, blood transfusion rate, length of hospital stay, length of catheterisation and complication rate were all similar in both groups. Conclusions: Prostate size should not be a factor determining a patient's suitability for LRP. Further follow-up is needed to assess the effect of prostate size on long-term functional and oncological results. (c) 2005 Published by Elsevier B.V.