Analysis of Complications Development Predictors after Radical Prostatectomy

Vladimir Vorobev; Vladimir Beloborodov; Vladimir Luchkevich; Dmitriy  Shmakov; Olga Baklanova; Stepan Sidorov; Bator Sharakshinov

doi:10.3889/oamjms.2021.7158

Authors

Vladimir Vorobev Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation
Vladimir Beloborodov Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation
Vladimir Luchkevich Department of Public Health, Economic and Management, North-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation
Dmitriy Shmakov Department of Faculty Surgery, Irkutsk State Medical University, Irkutsk, Russian Federation
Olga Baklanova Department of Urology, GBUZ State Oncology Hospital, Irkutsk, Russian Federation
Stepan Sidorov Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation
Bator Sharakshinov Department of General Surgery and Anesthesiology, Irkutsk State Medical University, Irkutsk, Russian Federation

DOI:

https://doi.org/10.3889/oamjms.2021.7158

Keywords:

Lymphocele, Prostatectomy, Prostate cancer, Urethral stricture, Urinary incontinence

Abstract

Introduction: The standard treatment for prostate cancer is radical prostatectomy (RP). This surgical technique results in typical complications such as intraoperative blood loss, urethral strictures (vesicourethral anastomosis), urinary incontinence, erectile dysfunction, lymphocele, and the ureter or rectum injury. The study aims to analyze the development of complications after radical prostatectomy.

Materials and methods: The article presents a retrospective analysis of clinical cases with an established diagnosis of prostate cancer from 2012 to 2018 in Irkutsk, Russian Federation. During this period, 52 patients met the study criteria. A multivariate analysis established Non-Nerve-sparing RRP (OR-0.9; 95% CI-1.9; -0.07; p=0.035) as a significant incontinence predictor after 2 years.

Results: Multivariate analysis also established previous transurethral operations as a significant predictor of the vesicourethral anastomosis stricture (OR 6.09; 95% CI 0.71; 11.4; p=0.026), which indicates a six times risk of developing a vesicourethral anastomosis stricture if the patient already had one or more transurethral surgery. Obesity (OR 0.12; 95% CI 0.03; 0.21; p = 0.008), diabetes (OR 2.3; 95% CI 0.45; 4.2; p = 0.015) and coagulopathy (OR 3.1; 95% CI 0.5; 5.7; p = 0.019) became independent predictors of lymphocele development.

Conclusions: The study revealed some new information on the possible predictors of such complications as urinary incontinence in the late period, the lymphocele, and stricture of the vesicourethral anastomosis. Some of the results require further study and confirmation.

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