Retrospective Study of Laparoscopic Radical Prostatectomy for Localized Prostate Cancer after Transurethral Resection of the Prostate Compared with Retropubic Radical Prostatectomy at the Same Institution

Background: Radical prostatectomy (RP) for localized prostate cancer after transurethral resection of the prostate (TUR-P) is technically difficult because of periprostatic adhesion and changes in the form of the prostate. The advantages of laparoscopic RP (LRP) over retropubic RP (RRP) include a less invasive operation through a small wound, a clearer field of vision, and reduced blood loss, and, therefore, LRP may represent the optimal method for RP after TUR-P. The present study compared clinical, oncological, and pathological outcomes between LRP and RRP after TUR-P at our institution. Methods: Twenty patients underwent TUR-P for benign prostatic hyperplasia, followed by LRP (12 patients) or RRP (8 patients) after localized prostate cancer was diagnosed at our institution from November 1998 through December 2006. Median patient age was 67.5 years (range, 52-73 years). The median duration of follow-up was 96 months (range, 60-144 months). Operative time, volume of blood loss, duration of indwelling urethral catheter use, degree of urinary incontinence, pathological findings, oncological outcomes, and complications were compared between LRP and RRP. Results: No significant difference in operative time or amount blood loss was recognized between LRP and RRP. Urinary incontinence in the early and late postoperative periods was significantly more severe after LRP than after RRP. Oncological outcomes and results of pathological examinations were comparable between LRP and RRP. Conclusion: We found no significant differences in clinical, pathological, and oncological outcomes, except for urinary incontinence, between LRP and RRP. (J Nippon Med Sch 2012; 79: 416-421)