Retzius-sparing versus Standard Robotic-Assisted Radical Prostatectomy: A Comparative Analysis of Functional and Oncological Outcomes in 500 patients.
BAUS ePoster online library. Kusuma V. Jun 24, 2019; 259542; P5-12 Disclosure(s): None to disclose
Mr. Venkata Kusuma
Mr. Venkata Kusuma
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There is a growing body of evidence showing the superiority of Retzius sparing approach (RS-RARP) in terms of early continence without compromising oncological outcomes. The aim of this prospective study was to compare and analyse the short term functional and oncological outcomes amongst men undergoing RARP for localised prostate cancer using either RS-RARP or standard RARP (anterior approach) technique.


Between March 2017 and April 2018, a total of 507 men underwent Robotic assisted radical prostatectomy in a tertiary referral centre. Of these, 241 patients had RS-RARP and 243 underwent a standard RARP. Patients were stratified as low, intermediate and high-risk using D'Amico classification. Post-operative complications, functional and oncological outcomes were compared. Univariate and multivariate logistic regression were used to assess the predictors of these outcomes.


There was no significant difference between the two groups with regards to age, prostate size stage and PSA. Table 1 shows the multivariate analysis, comparing different pre-operative factors (patient risk and stage), biopsy type and surgical approaches on positive margin outcomes whereas table 2 summarises analysis of functional outcomes in 6 weeks and 3 months. The operative time was significantly shorter in the RS-RARP approach.


Our analysis show that Retzius sparing approach achieves superior continence at 6 weeks without affecting short-term cancer control indicators such as positive margins. However, at three months, there was no difference noted in pad free rate. Longer follow-up is necessary to assess the impact of RS-RARP on cancer control.

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