Lymph Node Dissection and Pyuria as Predictors of Readmission After Robot-Assisted Radical Prostatectomy

Objectives: Robot-assisted radical prostatectomy (RARP) is widely performed as the standard surgical treatment for prostate cancer. However, few studies have comprehensively examined the factors associated with readmission after RARP. This study evaluated postoperative readmissions after RARP at our institution and retrospectively analyzed related clinical factors. Methods: We retrospectively reviewed 932 consecutive patients who underwent RARP for prostate cancer between January 2016 and April 2025 at our institution. Clinical variables such as baseline characteristics, perioperative factors, and pathological findings were examined. We investigated the readmission rate within 30 days after RARP and performed multivariate logistic regression analysis to identify independent predictors of readmission. Results: The 30-day readmission rate was 3.2% (30 of 932 patients). The median interval from discharge to readmission was 7 days, and the median length of stay during readmission was 10 days. The most common causes of readmission were symptomatic lymphoceles (n = 13, 43.3%) and vesicourethral anastomosis leakage (n = 6, 20.0%). Multivariate analysis revealed that the removal of ≥ 8 lymph nodes (OR = 2.14; 95% CI, 1.08–4.59; p = 0.047) and the presence of preoperative pyuria (OR = 4.58; 95% CI, 1.23–17.00; p = 0.049) were significant independent predictors of readmission. Conclusion: The removal of ≥ 8 lymph nodes and the presence of preoperative pyuria were identified as independent risk factors for early readmission after RARP. Incorporating these factors into preoperative risk assessment could contribute to reducing postoperative readmissions.