Lower urinary tract symptoms after robot-assisted radical prostatectomy: a systematic review

Area of Science:

• Urology
• Minimally Invasive Surgery
• Oncology

Background:

• Robot-assisted radical prostatectomy (RARP) is a key treatment for localized prostate cancer.
• It aims to balance oncological control with functional recovery, particularly urinary function.

Purpose of the Study:

• To systematically review and meta-analyze functional outcomes after RARP.
• Focus areas include lower urinary tract symptoms (LUTS), urinary continence, and quality of life.

Main Methods:

• Systematic search of PubMed, Embase, and Cochrane Library databases.
• Inclusion of randomized trials and observational cohorts (≥200 RARP patients) from the last 10 years.
• Random-effects meta-analysis to pool symptom scores and continence data.

Main Results:

• 18 studies with 16,207 patients were analyzed.
• Significant reduction in LUTS (IPSS) at 6 and 12 months post-RARP.
• Continence recovery progressed from 40-50% at 1 month to ~90% by 12 months.
• Retzius-sparing RARP and periurethral reconstruction correlated with earlier continence recovery.
• Improved quality of life, especially in patients with severe preoperative symptoms or larger prostates.

Conclusions:

• RARP leads to progressive continence recovery and improved LUTS, enhancing urinary-related quality of life.
• Surgical techniques, preoperative severity, and patient factors influence functional recovery outcomes.