Transvesical robot-assisted radical prostatectomy: initial experience and surgical outcomes

Area of Science:

• Urology
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted radical prostatectomy (RARP) is a standard treatment for localized prostate cancer.
• The transvesical approach to RARP is less commonly described.
• Evaluating outcomes of transvesical RARP is important for surgical technique refinement.

Purpose of the Study:

• To detail the techniques of transvesical robot-assisted radical prostatectomy (RARP).
• To assess the functional and oncological outcomes of transvesical RARP in patients with prostate cancer.

Main Methods:

• A cohort of 35 patients with localized prostate cancer underwent transvesical RARP using the da Vinci Si/Xi system.
• Preoperative data, surgical results, peri-operative complications, and functional outcomes (urinary continence, IIEF-5 scores) were collected.
• Follow-up was conducted for at least 12 months, including urodynamic studies and urethrocystography.

Main Results:

• The mean operating time was 150 minutes with an estimated blood loss of 100 mL.
• 32 patients achieved immediate urinary continence, with the remaining three continent by postoperative day 14.
• No significant changes in urodynamic parameters were observed, and no biochemical recurrence was noted during follow-up.

Conclusions:

• The transvesical approach is a feasible alternative for RARP in selected prostate cancer patients.
• Promising early results regarding postoperative urinary continence were observed.
• Long-term functional and oncological outcomes warrant further investigation.