Incidence, risk factors, and outcomes of rectal injury in radical prostatectomy

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2019. Background: Radical prostatectomy is a standard treatment option for localized prostate cancer. Rectal injury is one of the serious specific complications for this operation. Although its occurrence is rare in the literature, it contains significant morbidity. Objective: To report incidence, risk factors, and outcomes of patients with rectal injury associated with radical prostatectomy. Materials and Methods: Patients demographic data, operative data, and complications data were collected. Risk factors for rectal injury were analyzed. The treatment method of rectal injury and the outcomes of treatment were also described. Results: Between July 1, 2011 and July 31, 2017, the authors’ institute had performed 535 radical prostatectomy procedures. There were seven (1.3%) rectal injuries in the series. Possible risk factors for rectal injury are intermediate-risk and high-risk patients. Minimally invasive methods had a significant lower risk of rectal injury. The seven rectal injuries were successfully repaired by multilayers closure without colostomy or the need for further reoperation. Conclusion: Rectal injury is a rare but serious complication in radical prostatectomy procedures. Risk factors are difficult to identify because of the low incidence of this condition. Meticulous repair can reduce the morbidity from the complication.