Anatomical Analysis of Prostate and Surrounding Structures: Points to Consider during Radical Retropubic Prostatectomy

Sang Eun Lee, Seok-Soo Byun, Sung Kyu Hong, Hak Jong Lee, Yong June Kim, In Ho Chang, Myung Chul Gill
2006 Korean Journal of Urology  
Purpose: To investigate the prevalences of anatomical variations regarding prostate and its surrounding structures, and also the intra-and postoperative effects of such anatomical variations in performing radical retropubic prostatectomy (RRP). Materials and Methods: A retrospective analysis of 156 patients who received RRP for prostate cancer was performed. Patients records including the results preoperative radiologic evaluations were reviewed. For our analysis, patients were grouped
more » ... re grouped according to the anatomical variations relevant to prostate and surrounding structures shown on preoperative radiographs. Also, patients were interviewed via telephone as needed. Results: Prostate volume (mean: 41.4ml) measured from preoperative transrectal ultrasound correlated with estimated blood loss (EBL) during RRP (p=0.029). Interspinous diameter (mean: 1.69cm) measured on axial image of preoperative magnetic resonance imaging (MRI) was observed to be inversely correlated with operative time (p=0.010). And, patients with box-shaped deep dorsal vein (as demonstrated on axial view of MRI; 15.3%) were observed to have significantly less EBL during RRP (p=0.030). Also, EBL was significantly higher (p=0.013) for patients in which anterior portion of prostatic apex appeared to overlap and obscure membranous urethra (62.8%). Meanwhile, absence of the distal protrusion of apical region (21.8%) was observed to be associated with early (within 3 postoperative months) recovery of urinary continence (p=0.014). Conclusions: Our results suggest that various anatomical variations regarding prostate and its surrounding structure may exist as herein presented, and also that they may indeed have significant effects on both intra-and postoperative course regarding RRPs. Variations in the shape of prostatic apex may be significantly associated with recovery of continence after RRPs. (Korean J Urol 2006;47:568-577) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
doi:10.4111/kju.2006.47.6.568 fatcat:q3l2u4tipzeofhatzgrsixqxaq