Impact of preoperative antidepressant use on surgical and functional outcomes of robot assisted radical prostatectomy

Compare surgical outcomes of Robot‑Assisted Radical Prostatectomy (RARP) between patients with and without depression. This retrospective study included consecutive patients who underwent RARP at three tertiary hospitals between January 2021 and December 2023. Patients were divided into intervention and control groups based on the presence of a confirmed diagnosis of depression and the use of antidepressants for more than six months. prior to surgery. Depression, lower urinary tract symptoms (LUTS), and overall quality of life were assessed using the Self‑Rating Depression (SDS), Patient Health Questionnaire (PHQ), International Prostate Symptom Score (IPSS), and 36‑Item Short Form Health Survey (SF-36) scales. Other parameters included demographic characteristics, surgery-related indicators, and urinary incontinence. A total of 245 men underwent RARP surgery, and 205 patients (84%) completed the preoperative surveys and were analyzed. There were no significant differences in the demographic characteristics, initial PSA level, Gleason score, prostate volume, and T staging between the two groups. Additionally, both groups showed significant improvements in SDS scores, IPSS, SF-36-VT scores, and PHQ scores at the sixth month postoperatively compared to those preoperatively (all P < 0.05). Compared to the control group, the intervention group had higher preoperative and postoperative SDS and PHQ scores as well as lower SF-36 VT scores. Although there was no difference in the preoperative IPSS between the two groups, the intervention group had higher postoperative IPSS and lower rates of urinary incontinence recovery (all P < 0.05). Patients undergoing RARP who received preoperative antidepressant treatment for depression showed similar clinical symptom improvement post-surgery compared to those without depression; however, they experienced relatively more severe LUTS.