Relationship of Pelvimetric Diameters with Peroperative Outcomes, Complications, and Surgical Success in Patients Undergoing Perineal Radical Prostatectomy

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Abstract
Background: This study investigates the effect of pelvimetric measurements on intraoperative and postoperative outcomes in the open perineal radical prostatectomy procedure. Methods: Distance of the ischial spines (ISD), angle of symphysis pubis (ASP), angle of symphysis pubisseminal vesicles (ASS), distance between the prostate apex and anus (DAA), distance between seminal vesicles and anus (DSA), distance of pelvic outlet (DPO) measurements were determined in multiparametric magnetic resonance imaging. The effects of these pelvimetric measurements on perioperative factors were analyzed. Results: A total of 71 patients were included. Distance of the ischial spines was 9.0 Å} 0.82 mm, DPO 8.2 Å} 0.86 cm, DAA 4.8 Å} 1.2 cm, DSA 7.8 Å} 1.3 cm, ASP 63.7 Å} 7.2 degrees and ASS 44.9 Å} 6.5 degrees. It was found that a 1-cm increase in the ISD value resulted in a decrease of 9.19 minutes in the operation duration, a 1-cm increase in the DSA value caused an increase of 4.55 minutes in the operation duration, and a 1-cm increase in the ASS value caused a decrease of 0.76 minutes in the operation duration. A 1-cm increase in ASP resulted in 6.5 cm3 less blood loss and 1 unit increase in ASS resulted in 15.15 cm3 less blood loss. A 1-cm increase in ISD decreased anastomosis time by 1.7 minutes, whereas a 1-cm increase in DAA increased to 1.03 minutes. In the postoperative pathologic findings of the patients after radical prostatectomy, Gleason score 3 + 4 was the most common finding with 56.3%. Seminal vesicle invasion positivity was observed in 2 (2.8%) and extraprostatic invasion positivity in 18 (25.4%). Conclusion: Six parameters were examined with pelvimetric measurements had particular effects on operation duration, blood loss, anastomosis time, and complication development. Cite this article as: Arıkan Y, Danacıoğlu YO, Özcan A., et al. Relationship of pelvimetric diameters with peroperative outcomes, complications, and surgical success in patients undergoing perineal radical prostatectomy. Eurasian J Med. 2025, 57(4), 0877, doi:10.5152/eurasianjmed.2025.25877.

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