Urinary incontinence is a common sequela of robot-assisted radical prostatectomy and adversely affects quality of life. Advances in surgical technique preserve the pelvic anatomy to mitigate postoperative urinary incontinence. Pelvic-fascia-sparing techniques such as Retzius-sparing and hood with single-port or multi-port robotic approaches can improve outcomes.
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References
Wald, G. et al. Factors associated with recovery of urinary continence: a multicenter comparison of pelvic fascia-sparing and standard robotic-assisted radical prostatectomy. Eur. Urol. Focus https://doi.org/10.1016/j.euf.2025.06.005 (2025).
Egan, J. et al. Retzius-sparing robot-assisted radical prostatectomy leads to durable improvement in urinary function and quality of life versus standard robot-assisted radical prostatectomy without compromise on oncologic efficacy: single-surgeon series and step-by-step guide. Eur. Urol. 79, 839–857 (2021).
Kowalczyk, K. J. et al. Comparative outcomes of salvage retzius-sparing versus standard robotic prostatectomy: an international, multi-surgeon series. J. Urol. 206, 1184–1191 (2021).
Xu, J.-N., Xu, Z.-Y. & Yin, H.-M. Comparison of Retzius-sparing robot-assisted radical prostatectomy vs. conventional robot-assisted radical prostatectomy: an up-to-date meta-analysis. Front. Surg. 8, 738421 (2021).
Barakat, B. et al. Retzius sparing radical prostatectomy versus robot-assisted radical prostatectomy: which technique is more beneficial for prostate cancer patients (MASTER study)? A systematic review and meta-analysis. Eur. Urol. Focus 8, 1060–1071 (2022).
Wagaskar, V. G. et al. Hood technique for robotic radical prostatectomy—preserving periurethral anatomical structures in the space of Retzius and sparing the pouch of Douglas, enabling early return of continence without compromising surgical margin rates. Eur. Urol. 80, 213–221 (2021).
Kaouk, J., Valero, R., Sawczyn, G. & Garisto, J. Extraperitoneal single-port robot-assisted radical prostatectomy: initial experience and description of technique. BJU Int. 125, 182–189 (2020).
Purnomo, S. et al. Transperitoneal versus extraperitoneal approach for laparoscopic and robot-assisted radical prostatectomy: a systematic review and meta-analysis. Urol. Res. Pract. 49, 285–292 (2023).
Kaouk, J. H. et al. Single-port robotic transvesical partial prostatectomy for localized prostate cancer: initial series and description of technique. Eur. Urol. 82, 551–558 (2022).
Cheng, E. et al. Same-day discharge vs inpatient robotic-assisted radical prostatectomy: complications, time-driven activity-based costing, and patient satisfaction. J. Urol. 210, 856–864 (2023).
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Suzman, E., Li, A., Wald, G. et al. Pelvic-fascia-sparing techniques and outcomes with RARP. Nat Rev Urol (2025). https://doi.org/10.1038/s41585-025-01079-7
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DOI: https://doi.org/10.1038/s41585-025-01079-7
