Related Experiment Video
Updated: Oct 31, 2025
12:10
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
8.2K
Salvage Robotic-assisted Laparoscopic Radical Prostatectomy Following Focal High-Intensity Focused Ultrasound for
T Spitznagel1, J V Hardenberg2, F A Schmid1
1Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Urology
|June 29, 2021
Summary
Salvage robotic-assisted laparoscopic radical prostatectomy (S-RALP) after high-intensity focused ultrasound (HIFU) shows satisfactory oncological outcomes and similar functional results to primary procedures. Patients should be aware of a higher complication rate in S-RALP.
Area of Science:
- Urology
- Oncology
- Surgical Innovation
Background:
- Focal therapy using high-intensity focused ultrasound (HIFU) is an alternative treatment for prostate cancer.
- Assessing salvage options after focal therapy is crucial for managing disease recurrence.
Purpose of the Study:
- To compare the feasibility and outcomes of salvage robotic-assisted laparoscopic radical prostatectomy (S-RALP) with primary robotic-assisted laparoscopic radical prostatectomy (pRALP).
- To evaluate oncological and functional results of S-RALP following HIFU treatment.
Main Methods:
- A bicentric trial included patients undergoing S-RALP after prior HIFU for prostate cancer (WHO/ISUP Grade Group 2 or 3).
- Perioperative data, complications, and oncological/functional outcomes were analyzed.
- S-RALP patients were matched 1:2 with pRALP patients based on preoperative parameters.
Main Results:
- In 39 patients (13 S-RALP, 26 pRALP), operative times and blood loss were similar.
- Complication rates were higher in S-RALP (46.2%) versus pRALP (26.9%), including Clavien-Dindo III events.
- Adverse histological outcomes (≥pT3a, pN+, R1) were comparable (23.1% vs 26.9%), with similar PSA persistence and functional outcomes (incontinence, erectile function).
Conclusions:
- S-RALP is a feasible option for early relapse after focal HIFU, offering satisfactory early oncological control.
- Functional outcomes at one year post-S-RALP are comparable to pRALP.
- Patients must be informed about the increased risk of Clavien-Dindo III complications with S-RALP.
