Retzius-sparing robotic-assisted laparoscopic radical prostatectomy: racial considerations for 250 consecutive cases

Area of Science:

• Urology
• Surgical Oncology

Background:

• Prostate cancer treatment requires balancing oncologic control with functional outcomes like continence.
• The Retzius-sparing approach in robotic-assisted radical prostatectomy is gaining traction for its potential benefits.

Purpose of the Study:

• To evaluate functional and oncologic outcomes of Retzius-sparing robotic-assisted radical prostatectomy.
• To assess racial disparities in post-operative urinary continence recovery.

Main Methods:

• Prospective case series of 250 consecutive prostate cancer patients.
• Single surgeon, single center, robotic-assisted laparoscopic radical prostatectomy with Retzius-sparing approach.
• Continence defined as ≤1 pad/day; assessed at 1 month, 3 months, and 1 year post-op.

Main Results:

• Excellent 1-year continence rate of 92%.
• Caucasian patients showed earlier continence recovery (77% at 3 months) vs. African American patients (65%).
• Oncologic outcomes were favorable, with low positive margin rates (18.1% pT2, 44.4% pT3).

Conclusions:

• Retzius-sparing robotic-assisted radical prostatectomy is oncologically safe and yields high rates of urinary continence.
• Racial differences in the speed of continence recovery warrant further investigation.