Does Robotic Technology Mitigate the Challenges of Large Prostate Size?

Objectives For radical prostatectomy, the advantages of robotic surgery may facilitate precise dissection and improve functional outcomes. However, patients with larger prostates may still pose increased challenges because of impaired visualization and mobility in the pelvis. For this reason, we undertook a study to better understand the relationships between large prostate size and robotic prostatectomy outcomes with respect to intraoperative and pathologic factors. Methods Patients undergoing robotic-assisted radical prostatectomy from 2003 to 2008 at our institution were included in this retrospective study. Prostate size was categorized into 3 groups (100 g). We compared surgical and quality of life (Expanded Prostate Cancer Index Composite [EPIC] scores) outcomes among groups using generalized linear models and chi-square testing. Results Patients with the largest prostates had longer operative times (>100 vs 100 vs 100 vs 100 vs 100 vs