Purpose:
We sought to evaluate the feasibility and safety of open or robotic
radical prostatectomy (RP) after rectum, sigmoid or colon surgery. Materials
and Methods: Sixty-four patients, median age 65 years (range, 46-73)
who underwent RP after prior pelvic surgery were included. Twenty-four
(38%) underwent robotic and 40 patients (62%) underwent open RP.
Bilateral lymph nodes dissection and nerve preservation were performed
in 50 patients (78%) and 35 patients (55%) respectively. Variables
evaluated included demographic characteristics, perioperative
complications, functional and oncological outcomes. The median
hospitalization and follow-up periods were 2 days (range, 1-12) and 21
months (range,1-108 months) respectively. Results:
No conversions from robotic to open surgery were performed and there
were no intraoperative complications. Surgical margins were positive in
13 patients (20%), seminal vesicle involvement was detected in 6
patients (9%) and lymph nodes involvement was found in 2 patients (3%).
Postoperative complications included; lymphocele in 1 patient, urethral
stricture in 1 patient and bowel obstruction and persistent bladder
leakage in 2 patients. Eighty eight percentages of patients were
continent at 7 months and 80% of patients were able to achieve erection
with or without medical aid. Conclusion:
Open or robotic RP can be done safely and effectively in patients who
have previously undergone pelvic surgery. Although prior pelvic surgery
of the large intestine was associated with increased morbidity, it
shouldn't be contraindication for robotic or open RP.