Related Experiment Video
Updated: Jul 1, 2025
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Robot-assisted vs open retropubic radical prostatectomy: a propensity score-matched comparative analysis based on 15
Francesca Ambrosini1,2, Sophie Knipper1, Derya Tilki1,3
1Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Purpose:
To compare oncological, functional, and surgical outcomes of a large cohort of patients who underwent open retropubic radical prostatectomy (ORP) or robot-assisted radical prostatectomy (RARP).
Materials And Methods:
Data from 18,805 RPs performed with either the open or the robot-assisted approaches at a single tertiary referral center between 2008 and 2022 were analyzed. The impact of surgical approach on biochemical recurrence-free survival, salvage radiotherapy-free survival, and metastasis-free survival was analyzed by log-rank test and Kaplan-Meier analysis in a propensity score (PS)-based matched cohort. Intraoperative and postoperative surgical outcomes were assessed. One-week, 3-month, and 12-month continence rates and 12-month erectile function (EF) were analyzed.
Results:
No statistically significant differences in oncological outcomes were found between ORP and RARP. A slight statistically significant difference in favor of RARP was noted in urinary continence at 3 months (RARP vs. ORP: 81% vs. 77%, p = 0.007) and 12 months (91% vs. 89.3%, p = 0.008), respectively. The rate of EF was statistically significantly higher (60%) after RARP than after ORP (45%, p < 0.001).
Conclusion:
Both RARP and ORP yielded similar oncological outcomes. RARP offered a slight advantage in terms of continence recovery, but its clinical significance may be less meaningful. RARP resulted in significantly improved postoperative EF, suggesting a potential influence of both surgical experience and minimally invasive approach.
