Predicting Operational Difficulties and Outcomes of RARP Based on Preoperative Assessment - Introducing the PIODO Questionnaire

Preoperative assessment of patients undergoing RARP using an original questionnaire. The sum of the points obtained is presented as a number. The minimum value is 10 and maximum value is 34. The investigators' assumption is that the higher the score, the more difficult the surgery and the worse the functional and oncological outcome.

The angle between the pros¬tatic urethra and the posterior side of the pubic bone. Measured in degrees on MRI T2-weighted images.

The distance between the extension lines of the suprapubic ridge line and the prostate apical line. Measured in centimeters on MRI T2-weighted images.

The upper limit of MUL is the lower border of the peripheral zone of the prostate, dorsal to the membranous urethra. The lower limit of MUL is the origin of the penile base at the dorsal side of the urethral lumen. Measured in milimeters on MRI T2-weighted images.

Evaluation of the presence or absence of protrusion of the prostate into the bladder. If the tip of the prostate protruded to the base of the urinary bladder, protrusion of the prostate into the bladder was considered present. Measured in milimeters on MRI T2-weighted images.

Diameter from the sacral promontory to the most superior aspect of the pubic symphysis. Measured in centimeters on MRI T2-weighted images.

Diameter from the sacral promontory to the most inferior point of the pubic symphysis. Measured in centimeters on MRI T2-weighted images.

Diameter from the inferior aspect of the pubic symphysis to the sacrococcygeal junction. Measured in centimeters on MRI T2-weighted images.

Diameter from the inferior aspect of the pubic symphysis to the tip of the coccyx. Measured in centimeters on MRI T2-weighted images.

Diameter from anterior peritoneum to anterior border of coccyx (inner border). Measured in centimeters on MRI T2-weighted images.

Diameter between medial border of acetabulum. Measured in centimeters on MRI T2-weighted images.

Measured with the use of International Index of Erectile Function-5 (IIEF-5). The minimum value is 0 and maximum value is 25. The higher the score the better erectile function.

Presence of sexual activity marked as 1, lack of sexual activity marked as 0.

Presence of LUTS marked as 1, lack of symptoms marked as 0.

Prostate-specific antigen (PSA) serum level.

Prostate volume based on the MRI scan in milliliters.

Measured using Prostate Imaging Reporting and Data System (PI-RADS) assessment categories.

Histological grading of adenocarcinoma of the prostate, including use of the International Society of Urological Pathology (ISUP) modified Gleason grades. The minimum value us 1 and maximum value is 5. The higher the score the more advanced cancer.

Stage based on digital rectal examination (DRE) only in accordance with the EAU guidelines.

Weight and height will be combined to report body mass index (BMI) in kg/m^2

List of patients comorbidities.

Medications that can affect continence and/or erectile function - 1 if used, 0 if not.

Operative difficulties were defined as:

• Operative time of 3 hours or longer.
• Blood loss over 500 ml.
• Need for blood transfusion during surgery.
• Lack of nerve-sparing unrelated to high-risk carcinoma.
• Presence of intraoperative complications reported by the surgeon. Presence of operative difficulties marked as 1, lack of difficulties as 0.

Precence of postoperative complications during first 90 days after RARP - 1 if occured, 0 if not.

Measured with the Urinary Domain of the Expanded Prostate Cancer Index Composite (EPIC). The minimum value is 6 and maximum value is 28. The higher score the worse continence.