Comparing Robot-Assisted Radical Prostatectomy Approaches
Posted: Thursday, April 23, 2020
Spare the Retzius space and support improved postprostatectomy continence, according to the results of research published in The Journal of Urology. As described by Koon Ho Rha, MD, of Yonsei University College of Medicine, Seoul, and colleagues, their work was based on a single surgeon’s performance of 1,863 robot-assisted radical prostatectomies for prostate cancer between October 2005 and May 2018: 1,150 conventional, 713 incorporating the Retzius-sparing technique. The team successfully propensity matched 609 men from each cohort to evaluate whether early continence recovery differed depending on the technique.
As indicated by the Kaplan-Meier curve analysis—P < .001—Retzius-sparing prostatectomy was associated with a significantly better continence recovery rate during the 6-month study period. “Continence was assessed by the [urinary] pad count every month postoperatively until month 6 and was converted to a binary outcome,” Dr. Rha and co-investigators explained. The propensity matching took into account nine preoperative variables: age, body mass index, prostate-specific antigen level, biopsy Gleason grade group, clinical T stage, prostate volume on transrectal ultrasound, International Prostate Symptom Score (I-PSS), I-PSS quality-of-life score, and International Index of Erectile Function–5 score.
The team concluded that the Retzius-sparing technique “can be a candidate for future robot-assisted radical prostatectomy.” Not only does it support better early continence recovery, but it is marked by “a short operative time and early recovery compared [with] conventional robot-assisted radical prostatectomy.”
Disclosure: The study authors’ disclosure information can be found at aua.journals.org.
