Purpose: Obesity has been proven to affect the outcomes in open radical prostatectomy. However, the relationship between obesity and the outcomes of robot-assisted radical prostatectomy (RARP) was not conclusive. Herein, we aimed to investigate the impact of obesity on the clinical outcomes after RARP. Materials and Methods: From April 2016 to June 2020, 164 patients underwent RARP by a single experienced surgeon at our institute. Patients with previous transurethral resection of prostate (n = 30), hernioplasty (n = 13), and transperitoneal RARP (n = 26) were excluded. Finally, 105 patients were enrolled and divided into different groups according to their body mass index (BMI) and waist circumference (WC) using the definition of Taiwan National Health Institute. BMI was categorized into three groups (normal: BMI <24, overweight: BMI between 24 and 27, and obese: BMI ≥27 [kg/m2]). WC was categorized into two groups (normal: WC <90 and central obesity: WC ≥90 [cm]). Perioperative outcomes and functional outcomes including preoperative, postoperative erectile function, and postoperative continence status were evaluated. Results: Among BMI groups, 29 patients were normal, 43 patients were overweight, and 33 patients were obese. Console time and sum time showed a significant difference in different BMI groups (P = 0.034 and 0.016, respectively). Of the 101 patients with available magnetic resonance imaging, 74 patients' WC were normal, and 27 patients were central obese. Blood loss in central obesity group was significant more than normal WC group (300 ml vs. 200 ml, P = 0.04). No significant differences were observed in pathological and functional outcomes in both groups. Conclusion: Obesity and central obesity seemed to result in longer operation time and more blood loss in extraperitoneal RARP while functional outcomes can be maintained regardless of the obesity degree. Large-scale studies are necessary to further explore the relationship between obesity and the outcomes of RARP in future.

Purpose: Prostate biopsy induced prostate hemorrhage and periprostate tissue inflammation which raised the concerns of increasing difficulty even in the era of robot-assisted radical prostatectomy (RARP). To evaluate the correlation between postoperative outcomes and the interval after biopsy, we compared surgical outcomes in different time interval (≤4 weeks, 4–8 weeks, and ≥8 weeks). Materials and Methods: We collected patients with localized prostate cancer who underwent RARP by a single experienced surgeon at our institute between April 2016 and February 2019. The complicated statuses such as previously transurethral resection of prostate, grossly nodal positive disease, or locally advanced disease were excluded. A total of 83 patients were enrolled retrospectively according to the regulation of the institutional review board in the institute. The patients were divided into three groups according to the time interval between prostate biopsy and RARP (≤4 weeks, 4-8 weeks and ≥ 8 weeks). The demographic information and perioperative and postoperative outcomes were collected and analyzed. Results: Regarding preoperative characteristics, there were similarities in the three groups. Concerning intraoperative outcomes, statistical difference was observed in mean estimated blood loss (253.1 vs. 158.9 vs. 170.9 ml, P= 0.047). In addition, operative time was similar among three groups (221.9 vs. 248.5 vs. 226.7, P= 0.199). There was no difference in positive surgical margin rate among three groups. The time interval groups did not correlate to prolonged days either urinary catheter indwelling or hospitalization (P > 0.05). There was no difference in decreased erection hardness scores at 12 months between 3 groups (−0.75 vs. −0.77 vs. −0.57, P= 0.556). Conclusion: In our experience, RARP can be effectively and safely performed in different time intervals after prostate biopsy without increasing total operative time or adversely compromising postoperative functionally and oncologic outcomes. However, performing RARP < 4 weeks after prostate biopsy did probably have the risk of increase estimated blood loss.