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The patient characteristics are shown in Table?1. The mean BMI was 23.6?kg/m2, and 43 patients (28.3%) were stratified as high BMI. A total of 39 patients (25.7%) had a history of previous lower abdominal surgery. A total of 22 patients (14.5%) had a history of repeated TRNB. Initial TRNB were carried out at a mean PSA of 8.8?ng/mL. Second TRNB were carried out at a mean PSA of 10.5?ng/mL after 17.4 months of the initial TRNB in 16 patients. Third TRNB were carried out at a mean PSA of 12.1?ng/mL after 41.2 months of the second TRNB in three patients. The fourth TRNB was carried out at a PSA of 14.6?ng/mL after 7 months of the third TRNB in one patient. The mean number of punctures in the initial, second, third and fourth TRNB was 10.6, 13.7, 13.7 and 16.0, respectively. A total of 47 patients (30.9%) received NHT, and the mean cross-section area of the Retzius space was 26.3?cm2. The Gleason http://www.selleckchem.com/products/CP-673451.html score of the biopsy specimens was 6 in 41 patients, 7 in 87 patients, 8 in 15 patients and 9 in 9 patients. The cT stage was cT1c in 44 patients, cT2a in 79 patients, cT2b in one patient, cT2c in 26 patients and cT3a in two patients. http://www.selleckchem.com/products/rxdx-106-cep-40783.html According to the D'Amico risk classification, 32, 72 and 48 patients were classified as low, intermediate and high risk, respectively. The total OT and step durations are shown in Table?2. The mean total OT was 190.7?min, and BMI was significantly correlated with total OT (P? https://en.wikipedia.org/wiki/Crotamiton predictors of prolonged OT (BMI: P?=?0.032, OR?=?2.319 and prostate weight: P?=?0.041, OR?=?1.034) (Table?3). The duration of this step in high BMI cases was significantly longer than that of normal BMI cases (P?=?0.018). Similarly, the duration in the cases with a history of previous lower abdominal surgery was significantly longer than that in the cases without (P?=?0.002). Both a high BMI and a history of previous lower abdominal surgery were independent predictors of prolonged step?1 (BMI: P?=?0.034, OR?=?1.272, and a history of previous lower abdominal surgery: P?=?0.013, OR?=?3.968). A significant correlation between prostate weight and the duration of step?2 was shown (P?=?0.002, r?=?0.254), and it was an independent predictor of a prolonged step?2 (P?=?0.024, OR?=?1.028). The duration of this step in high BMI cases was significantly longer than that of normal BMI cases (P?=?0.046), and it was an independent predictor of a prolonged step?3 (P?=?0.006, OR?=?1.221).