Magnetic resonance imaging pelvimetry and vesicourethral anastomosis time in laparoscopic radical prostatectomy

To determine whether preoperative pelvic measurements obtained from multiparametric prostate magnetic resonance imaging are associated with vesicourethral anastomosis time and other perioperative outcomes after laparoscopic transperitoneal radical prostatectomy. This retrospective cohort included 112 patients treated from March 2021 to September 2024. Sixteen pelvimetric variables were measured on preoperative images. The primary outcome was anastomosis time; secondary outcomes were non-anastomotic operative time, estimated blood loss, and change in hemoglobin. Associations were examined using linear regression, with regression coefficients, 95% confidence intervals, and coefficients of determination reported. Mean anastomosis time was 1071.54 ± 250.68 s. In the forced-entry model including all 112 patients, pelvic cavity index (coefficient − 5.657 s/unit, 95% confidence interval − 11.019 to − 0.295; p = 0.039) and bony width index (− 121.564 s/unit, − 218.844 to − 24.284; p = 0.015) were associated with shorter anastomosis time; the model explained 10.4% of variance. Prostate volume was associated with longer non-anastomotic operative time (0.623 min/mL, 0.342 to 0.904; p < 0.001; 14.9% explained variance) and greater blood loss (1.943 mL/mL, 0.771 to 3.116; p = 0.001; 8.9% explained variance). Pelvic cavity and bony width indices were associated with anastomosis time, while prostate volume was associated with non-anastomotic operative time and estimated blood loss. Given the low explained variance, these findings should be considered exploratory and require prospective external validation before any clinical use.