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Updated: Jun 21, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy

Retzius-Sparing Robot-Assisted Radical Prostatectomy

Published on: May 19, 2022

Trifecta outcomes after robotic-assisted laparoscopic prostatectomy.

Sergey A Shikanov¹, Kevin C Zorn, Gregory P Zagaja

¹Department of Surgery, University of Chicago Medical Center, Chicago, IL 60637, USA. sergeyshikanov@gmail.com

|July 14, 2009

Summary

Robotic-assisted laparoscopic prostatectomy (RALP) achieves trifecta outcomes comparable to open surgery. However, continence and potency assessment methods significantly impact reported success rates.

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Area of Science:

Urology
Surgical Oncology
Robotic Surgery

Background:

The trifecta outcome (continence, potency, undetectable PSA) after radical prostatectomy is a key measure of success.
Standardization of continence and potency definitions is lacking, hindering comparison of published results.
Previous estimates for trifecta rates after open radical prostatectomy are around 60% at 1-2 years.

Purpose of the Study:

To evaluate trifecta outcomes after robotic-assisted laparoscopic prostatectomy (RALP).
To compare RALP trifecta outcomes using literature-reported definitions versus validated questionnaire data.
To assess the impact of different evaluation tools on reported continence and potency rates.

Main Methods:

Prospective analysis of a robotic-assisted laparoscopic prostatectomy (RALP) database.

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Included were continent and potent men with bilateral nerve-sparing surgery and >/= 1 year follow-up.

Continence and potency were assessed via surgeon interview (subjective) and UCLA Prostate Cancer Index questionnaire (objective) at multiple time points.

Main Results:

Among 380 eligible patients, subjective assessment yielded trifecta rates of 34% (3 mo) to 76% (24 mo).
Objective assessment (questionnaire) resulted in significantly lower trifecta rates: 16% (3 mo) to 44% (24 mo).
The difference in trifecta rates between subjective and objective evaluations was statistically significant at all time points (P < .0001).

Conclusions:

Robotic-assisted laparoscopic prostatectomy (RALP) demonstrates trifecta outcome rates comparable to open surgery.
The choice of evaluation tool (subjective interview vs. objective questionnaire) significantly influences reported continence and potency rates.
Standardized definitions are crucial for accurate reporting and comparison of surgical outcomes.