EURURO Vol. 72 No. 3

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men had negative lateral/posterior margins. For the
17 patients, perioperative data showed a fluid loss (blood
and urine) of 300 ml (interquartile range [IQR]: 200–400),
and perioperative complications were grades 1–2 ).
3.3. Postoperative clinical outcomes
shows the clinical, biochemical, and pathologic
outcomes. Median nadir PSA value was 0.4 ng/ml (0.3–0.7),
representing a reduction of 8.7 ng/ml (94%; 95% confi-
dence interval (CI), 7.3–10.2) compared with baseline PSA.
Median time to achieve PSA nadir was 3 mo.
shows PSA variations from the nadir value. PSA outcomes
were not suspicious for cancer during follow-up in 13 of
17 patients (76%). Of these, three patients had a PSA rise
with a velocity <0.10 ng/ml per year (cases 4, 5, and 7) and
doubling time of 6.1 yr (case 5) a); mpMRI showed
residual BPH at the prostate base as the most likely cause
[(Fig._2)TD$FIG]
Fig. 2 – Case 17 (prostate-specific antigen [PSA] 7.13 ng/ml; prostate volume 73 cm3]. Isolated anterior 2.4-cm3 lesion suspicious at magnetic resonance
imaging (MRI) in the anterior fibromuscular stroma on the midline and anterior left transition zone lobe (arrows). (a) MRI transverse T2. (b) MRI
transverse apparent diffusion coefficient map. (c) MRI transverse dynamic contrast-enhanced sequences. Targeted biopsies were positive for 6-mm
Gleason score (GS) 6 (3 + 3) cancer. (d) MRI T2 parasagittal view showed anterior cancer area at the anterior and inferior aspect (arrow). (e) Fixed
midsagittal section showed yellow area suspected of malignancy at the anterior and inferior aspect (arrow). (f) Hematoxylin and eosin whole-mount
sagittal histologic section confirmed cancer (red dotted line) area of 4 cm3, GS 7 (4 + 3), pT2, R0, and postoperative PSA of 0.4 ng/ml at 3 mo.
BN = bladder neck.
Table 2 – Perioperative and postoperative clinical data of the 17 patients included for anterior partial prostatectomy
Perioperative data
Operative time, min, median (IQR) 150 (148–188)
Fluid loss (blood and urine), ml, median (IQR) 300 (200–400
Bladder catheter removal, d, median (IQR) 7 (6–7)
Postoperative complications
Urinary infection, Clavien-Dindo grade 2 Treated with antibiotics in two cases (12%)
Transient anastomotic leak, Clavien-Dindo grade 2 Present in one case (case 2; 6%), resolved spontaneously with 10-d catheter
drainage
Transient intestinal ileus, Clavien-Dindo grade 2 Present in one case (case 1; 6%), resolved with transanal exsufflation tube
IQR = interquartile range.
* After the first five consecutive surgeries in an 18-mo period, there were no transfusions.
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