Inflammatory bowel disease vs. adverse in-hospital outcomes after radical prostatectomy

Introduction: The effect of inflammatory bowel disease (IBD) on adverse in-hospital outcomes after radical prostatectomy (RP) for nonmetastatic prostate cancer (PCa) is not well known. Materials and Methods: Descriptive analyses, propensity score matching and multivariable logistic regression models were used within the National Inpatient Sample (2000–2019) RP patients, after stratification according to Crohn's disease (CD) vs. ulcerative colitis (UC) vs. no-IBD, and RP type (minimally invasive [MIRP] vs. open [ORP]). Results: Of 251,334 RP patients, 486 (0.2%) had CD vs. 446 (0.2%) UC. In CD patients vs. no-IBD counterparts, MIRP (n = 223) independently predicted higher rates of adverse in-hospital outcomes in 3/15 categories, including overall (OR:1.64, P < 0.01) and postoperative (OR:1.73, P < 0.01) complications. Conversely, in CD patients vs. no-IBD counterparts, ORP (n = 263) independently predicted higher rates of adverse in-hospital outcomes in 5/15 categories, including also overall (OR:1.37, P < 0.05), and postoperative (OR:1.44, P < 0.05) complications. In UC patients vs. no-IBD counterparts, MIRP (n = 218) independently predicted higher rates of adverse in-hospital outcomes in only 1/15 categories, namely prolonged length of stay (OR:1.64, P < 0.001). Conversely, in UC patients vs. no-IBD counterparts, ORP (n = 228) independently predicted higher rates of adverse in-hospital outcomes in 3/15 categories, including overall (OR:1.49, P < 0.05) and intraoperative (OR:2.31, P < 0.01) complications. Conclusion: In the current analysis, direct comparisons with no-IBD patients showed worse in-hospital outcomes for both CD and UC patients, with adverse in-hospital outcomes indirectly appearing more severe in CD than in UC patients. In both subgroups, MIRP was associated with fewer adverse outcomes than ORP, based on comparison with no-IBD patients.