Blood loss during radical retropubic prostatectomy: relationship to morphologic features on preoperative endorectal magnetic resonance imaging

Coakley, Fergus V; Eberhardt, Steven; Wei, David C; Wasserman, Evan S; Heinze, Stefan B.J; Scardino, Peter T; Hricak, Hedvig

« Previous Next »Urology
Volume 59, Issue 6 , Pages 884-888, June 2002

Blood loss during radical retropubic prostatectomy: relationship to morphologic features on preoperative endorectal magnetic resonance imaging☆

Fergus V Coakley
- Reprint requests: Fergus Coakley, M.D., Department of Radiology, University of California, San Francisco, School of Medicine, Box 0628, M-372, 505 Parnassus Avenue, San Francisco, CA 94143-0628, USA
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Steven Eberhardt
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
David C Wei
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Evan S Wasserman
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Stefan B.J Heinze
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Peter T Scardino
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
Hedvig Hricak
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

Received 13 November 2001; received in revised form 4 February 2002; accepted 4 February 2002.

Abstract

Objectives. To determine whether morphologic features at preoperative magnetic resonance imaging (MRI) are related to intraoperative blood loss during radical retropubic prostatectomy.

Methods. Endorectal MRI was performed in 143 patients with newly diagnosed prostate cancer before radical retropubic prostatectomy. Two independent readers rated the prominence of the periprostatic veins (on the basis of number and size) at four anatomic sites on a 3-point scale. Other features analyzed were prostate volume and interspinous diameter.

Results. A prominence of the anterior and posterior apical periprostatic veins was positively associated with blood loss (correlation coefficient = 0.22 and 0.17 and P <0.01 and <0.05, respectively). Blood loss was not related to prostate volume (correlation coefficient = 0.02, P = 0.8) or interspinous diameter (correlation coefficient = 0.01, P = 0.9). The site-specific scores of both readers demonstrated positive agreement, with Pearson’s correlation coefficients of 0.51 to 0.65 (P <0.01).

Conclusions. A marked prominence of the apical periprostatic veins on preoperative MRI is associated with greater intraoperative blood loss during radical retropubic prostatectomy. Other morphologic factors appear unrelated to the amount of intraoperative blood loss.