Oncological and functional outcomes of Retzius-sparing vs. standard robot-assisted radical prostatectomy: evidence on...

RS-RARP appears to offer better functional outcomes compared to traditional RARP, particularly in terms of urinary continence. However, its oncological outcomes remain a topic of debate. Additionally, there is a lack of comparative analyses focusing on results from randomized-controlled trials (RCTs) in the current review. A comprehensive examination and synthesis of existing RCTs research were conducted to compare follow-up outcomes of RS-RARP versus RARP in PCa patients. A comprehensive search was conducted in PubMed, Web of Science, and the Cochrane Library, and SpringerLink databases for that compare RS-RARP to RARP before December 1st, 2024. Oncological and functional outcomes were used as outcomes to compare. This meta-analysis included 549 people from five research papers. RS-RARP outperformed RARP in immediate continence recovery, with an odds ratio of 0.39, a 95% confidence range of 0.18-0.81, and a p value of less than 0.05. Later follow-ups showed that RARP hampered the patient's functional recovery. At every time point, the RS-RARP group had less incontinence than the RARP group. For these reasons: 1 month (OR: 0.38, 95% CI 0.21-0.69), 3 months (OR: 0.34, 95% CI 0.13-0.90), 6 months (OR: 0.25, 95% CI 0.15-0.40), and 12 months (OR: 0.36, 95% CI 0.16-0.80). p < 0.05. There were no significant differences in BCR rates between RS-RARP and RARP (OR: 1.16, 95% confidence interval: 0.42 to 3.19, p = 0.78). This was the researchers' conclusion. The odds ratio of 0.45, with a 95% confidence range of 0.29 to 0.70 and a p value of less than 0.05, showed that RS-RARP was linked with more PSMs. In terms of functional recovery after surgery, our results show that RS-RARP is much better than RARP. Having said that, it does come with a greater incidence of PSMs. When comparing the two methods for BCR, we found no statistically significant differences. Based on these findings, RS-RARP may be considered as a surgical option for patients with prostate cancer; nevertheless, the choice should be made taking into account the surgeon's skill level and the patient's unique situation. To thoroughly assess the effects of these two techniques, further randomized-controlled studies are required, ideally with large sample numbers, multicenter participation, and long-term follow-up.