{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:56:59Z","timestamp":1785736619703,"version":"3.56.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T00:00:00Z","timestamp":1727740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Conventionally, confirmation of clinically significant prostate cancer (csPCa) (Gleason grade group \u2265 2) involves an initial multiparametric magnetic resonance imaging (mpMRI) followed by biopsy. Prostate biopsy incurs inherent risks of infection, bleeding, patient discomfort, and a 6-week delay before robot-assisted laparoscopic radical prostatectomy (RALP). We explored the feasibility of immediate RALP in men with PIRADS 5 lesions without preceding biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>\n                      After obtaining institutional review board approval, a prospective analysis was conducted on 235 patients with PIRADS 5 lesions on mpMRI from December 2018 to February 2023. Patients were divided into 2 groups as follows: Group NoBiopsy (biopsy not done before RALP, cases,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 118) and Group YesBiopsy (biopsy done before RALP, controls,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 117). Baseline preoperative, intraoperative, and postoperative parameters were analyzed. Functional outcomes were monitored at 1, 3-, 6-, 9-, and 12-months follow-up post-RALP. Statistical analysis was performed using SPSS and STATA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Ninety-five percent of cases and 87.17% controls had csPCa on final pathology post-RALP. Multivariable analysis did not find significant association between biopsy status and csPCa. Abnormal digital rectal examination (DRE), family history, preoperative PSA, and MRI lesion volume predicted csPCa. Significant differences were observed in console time (NoBiopsy vs. YesBiopsy, 60 \u00b1 10 vs. 70 \u00b1 9 minutes,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and estimated blood loss (80 \u00b1 20 vs. 100 \u00b1 30 mL,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.01) between groups. At 6 months post-RALP, 96% of men in Group NoBiopsy were continent, compared with 88% of men in Group YesBiopsy (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.04). All men in the study cohort were continent (0 pads) at 12 months post-RALP. Ninety-eight percent of cases and 92% of controls at 9 months and 12 months, respectively, were able to have penetrative sex with or without PDE-5 inhibitors post-RALP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>RALP without antecedent prostate biopsy in men with PIRADS 5 lesions demonstrated substantial csPCa detection rates and superior functional outcomes, warranting further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2024.0124","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T13:48:13Z","timestamp":1715867293000},"page":"1062-1069","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Robot-Assisted Radical Prostatectomy in PIRADS 5 Lesions Without Prior Biopsy: Is Biopsy Really Necessary in This Cohort?"],"prefix":"10.1177","volume":"38","author":[{"given":"Shirin","family":"Razdan","sequence":"first","affiliation":[{"name":"Department of Urology, Icahn School of Medicine at Mount Sinai Hospital, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Parekh","sequence":"additional","affiliation":[{"name":"Larkin Palm Springs Hospital, Hialeah, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelia K.","family":"Watts","sequence":"additional","affiliation":[{"name":"Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jainer","family":"Munoz","sequence":"additional","affiliation":[{"name":"International Robotic Prostatectomy Institute, Doral, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayesh","family":"Parmar","sequence":"additional","affiliation":[{"name":"Larkin University, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2828-6499","authenticated-orcid":false,"given":"Nile M.","family":"Khanfar","sequence":"additional","affiliation":[{"name":"Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy\u2014Palm Beach, Nova Southeastern University, Palm Beach Gardens, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Woodhouse","sequence":"additional","affiliation":[{"name":"Unique Imaging, Miami Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5728-7063","authenticated-orcid":false,"given":"Sanjay","family":"Razdan","sequence":"additional","affiliation":[{"name":"International Robotic Prostatectomy Institute, Doral, Florida, USA."},{"name":"Larkin Health System, Miami, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,10,1]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.3712"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa068"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21601"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2020.12.004"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32401-1"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210194"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.4102\/sajr.v25i1.2062"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/ijir.2012.9"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005392-200102000-00023"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002854"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15041266"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.11.019"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14143497"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41824-023-00182-5"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-023-00782-z"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30569-2"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2022.04.017"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003492"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)00957-2"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s003300000598"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.4103\/iju.IJU_158_18"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2020.10.016"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prnil.2020.01.001"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.05.094"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-023-03924-y"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24280"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04371-6"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-023-06556-y"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-073983"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.002"}],"container-title":["Journal 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