Retzius-Sparing versus Standard Robot-Assisted Radical Prostatectomy: A Comparative Prospective Study of Nearly 500 Patients

No AccessJournal of UrologyAdult Urology1 Mar 2021Retzius-Sparing versus Standard Robot-Assisted Radical Prostatectomy: A Comparative Prospective Study of Nearly 500 PatientsThis article is commented on by the following:Editorial Comment Paolo Umari, Christopher Eden, Declan Cahill, Michele Rizzo, Dominic Eden, and Prasanna Sooriakumaran Paolo UmariPaolo Umari *Correspondence: Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Via Paolo Solaroli 17, 28100Novara, Italy telephone: +44(0)7309643824 or +39(0)3313321600; E-mail Address: [email protected] Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy , Christopher EdenChristopher Eden Santis Clinic, London, United Kingdom , Declan CahillDeclan Cahill Santis Clinic, London, United Kingdom , Michele RizzoMichele Rizzo Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy , Dominic EdenDominic Eden Santis Clinic, London, United Kingdom , and Prasanna SooriakumaranPrasanna Sooriakumaran Santis Clinic, London, United Kingdom View All Author Informationhttps://doi.org/10.1097/JU.0000000000001435AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared standard robot-assisted radical prostatectomy and Retzius-sparing robot-assisted radical prostatectomy in a multicenter study using prospective patient reported outcome measures of functional recovery and quality of life plus standard pentafecta outcomes. Materials and Methods: Patient and physician reported data on 483 patients who underwent robot-assisted radical prostatectomy and Retzius-sparing robot-assisted radical prostatectomy from August 2017 to April 2020 by 3 experienced surgeons had been prospectively collected. Perioperative and pentafecta outcomes were analyzed using SPSS software. Patient reported outcome measures for urinary function, erectile function and quality of life were reported at baseline and at 7 days and 1, 3, 6, 9 and 12 months postoperatively. Results: A total of 201 patients underwent robot-assisted radical prostatectomy and 282 had Retzius-sparing robot-assisted radical prostatectomy. Patient and tumor characteristics were similar except for fewer low risk and more intermediate risk disease in robot-assisted radical prostatectomy vs Retzius-sparing robot-assisted radical prostatectomy (p <0.001). High risk disease was similar between groups (p=0.071). Immediate urinary continence was higher in Retzius-sparing robot-assisted radical prostatectomy group (70.4% vs 58.1%, p=0.02), with less nocturnal enuresis prevalence (p=0.011) and bother (p=0.009) with no significant differences afterwards. A better quality of life (p=0.004) was reported 1 week after surgery. No other differences in functional or quality of life outcomes, perioperative parameters, complications or margin rates were found. Conclusions: Retzius-sparing robot-assisted radical prostatectomy is associated with better immediate continence than anterior robot-assisted radical prostatectomy with no differences in longer-term functional recovery, quality of life or other important outcomes. The overall similarity in outcomes between groups lends support to the view that the surgical technique matters less than the surgeon performing it. References 1. : Pentafecta: a new concept for reporting outcomes of robot-assisted laparoscopic radical prostatectomy. 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Google Scholar © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byBahouth Z, Laniado M, Fowler R and Charlesworth P (2021) Positive Surgical Margins Rate of Retzius-Sparing Robot-Assisted Radical Prostatectomy in a Contemporary, Unselected CohortJournal of Urology, VOL. 207, NO. 3, (609-616), Online publication date: 1-Mar-2022.Smith J (2020) This Month in Adult UrologyJournal of Urology, VOL. 205, NO. 3, (647-648), Online publication date: 1-Mar-2021.Kowalczyk K, Madi R, Eden C, Sooriakumaran P, Fransis K, Raskin Y, Joniau S, Johnson S, Jacobsohn K, Galfano A, Bocciardi A, Hwang J, Kim I and Hu J (2021) Comparative Outcomes of Salvage Retzius-Sparing versus Standard Robotic Prostatectomy: An International, Multi-Surgeon SeriesJournal of Urology, VOL. 206, NO. 5, (1184-1191), Online publication date: 1-Nov-2021.Related articlesJournal of Urology29 Dec 2020Editorial Comment Volume 205Issue 3March 2021Page: 780-790 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsrobotic surgical proceduresprostatectomyMetricsAuthor Information Paolo Umari Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy *Correspondence: Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Via Paolo Solaroli 17, 28100Novara, Italy telephone: +44(0)7309643824 or +39(0)3313321600; E-mail Address: [email protected] More articles by this author Christopher Eden Santis Clinic, London, United Kingdom Financial and/or other relationship with Santis. More articles by this author Declan Cahill Santis Clinic, London, United Kingdom More articles by this author Michele Rizzo Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy More articles by this author Dominic Eden Santis Clinic, London, United Kingdom More articles by this author Prasanna Sooriakumaran Santis Clinic, London, United Kingdom More articles by this author Expand All Advertisement PDF downloadLoading ...