Adult Urology Effect of Prostate Weight on Operative and Postoperative Outcomes of Robotic-Assisted Laparoscopic Prostatectomy Kevin C. Zorn, Marcelo A. Orvieto, Albert A. Mikhail, Ofer N. Gofrit, Shang Lin, Anthony J. Schaeffer, Arieh L. Shalhav, and Gregory P. Zagaja OBJECTIVES To determine the effect of prostate weight (PW) on robotic laparoscopic radical prostatectomy (RLRP) outcomes. The effect of PW on surgical and pathologic outcomes has been reviewed in open and laparoscopic prostatectomy series. Little is known about its effects during RLRP. METHODS From February 2003 to November 2005, 375 men underwent RLRP. Patients were divided into four groups on the basis of the pathologic PW: group 1, less than 30 g; group 2, 30 g or more to less than 50 g; group 3, 50 g or more to less than 80 g; and group 4, 80 g or larger. The groups were compared prospectively. Continence and sexual function were assessed using validated questionnaires. RESULTS Of the 375 patients, 20, 201, 123, and 31 had a PW of less than 30 g, 30 g or more to less than 50 g, 50 g or more to less than 80 g, and 80 g or larger, respectively. A significant difference was found in age and prostate-specific antigen values among the four groups(P ⬍0.001).No significant differences in operative time, estimated blood loss, transfusion rate, hospital stay, length of catheterization, and complication incidence were observed among the four groups. The overall rate of positive surgical margins was significantly different among the groups (P ⫽ 0.002), demonstrating a trend of increasing positive surgical marginswith a lowerPW. Within the patients with Stage pT2, a significant increase in positive surgical margins was found with lower PWs (P ⫽ 0.026). The objective return of baseline and subjective sexual and urinary function, as determined by questionnaire scores, was not affected by the PW. CONCLUSIONS RLRP can be performed safely and with similar perioperative outcomes in men, regardless of the PW. We found a significant inverse relationship between surgical margin status and PW, specifically in those with Stage pT2 disease. UROLOGY 69: 300 –305, 2007. © 2007 Elsevier Inc. T he impactof prostate weight (PW) on radical prostatectomy has been studied in laparoscopic radicalprostatectomy (LRP) and open radical prostatectomy (ORP) series. Although both surgical ap- proaches have consistently demonstrated an inverse re- lationship between positive surgical margin (PSM) rates and PW, 1– 4 ORP series have correlated larger prostate prostate volumes have correlated with increased opera- tive time in most LRP reports, 4,6,7 no such effect has been observed in ORP series. 2 The functional outcomes after LRP and ORP have also been addressed. PW has not been found to affect either potency or continence, re- gardless of the surgical approach. 2,4 The effectsof PW on outcomesfor roboticLRP