Related Experiment Video
Updated: May 14, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Late Functional Outcomes After Robot-Assisted Radical Prostatectomy: Impact of Baseline and Perioperative Risk
Hanka Princlova1,2, Oleg Izmaylov1,2, Minh Nguyet Tranova1,2
1Department of Urology, University Hospital Hradec Kralove, 50005 Hradec Kralove, Czech Republic.
Introduction:
Late functional outcomes remain major determinants of quality of life after robot-assisted radical prostatectomy (RARP). Although several baseline and perioperative factors have been linked to postoperative stress urinary incontinence (SUI) and erectile dysfunction (ED), their cumulative effect remains incompletely characterized in large real-world cohorts.
Materials And Methods:
This retrospective single-center study included 862 consecutive patients undergoing RARP for localized prostate cancer. All endpoints were assessed at a fixed 12-month follow-up visit; therefore, a median follow-up beyond this predefined time point was not applicable. Outcomes were derived from patient-reported information documented during routine follow-up and comprised pad use, ED, and urethral anastomotic stricture. Age, body mass index (BMI), console time, estimated blood loss, and prostate weight were selected a priori based on clinical relevance and uniform availability and were analyzed using univariable and multivariable logistic regression. A simple exploratory composite risk score (0-5 points) was constructed by assigning one point for each predefined adverse factor.
Results:
At 12 months, 50.0% of patients were pad-free, 85.6% achieved social continence (0-1 pad/day), 14.5% had clinically significant incontinence (>1 pad/day), 71.5% had chart-documented ED, and 1.0% developed urethral anastomotic stricture. In multivariable analysis, age (OR 1.039, 95% CI 1.018-1.059) and prostate weight (OR 1.011, 95% CI 1.004-1.018) independently predicted SUI, while age was the only independent predictor of ED (OR 1.029, 95% CI 1.007-1.050). No predictor of stricture was identified. The composite score showed an exploratory dose-response association with SUI (OR 1.364 per point, 95% CI 1.208-1.541; AUC 0.597) and a weaker association with ED (OR 1.149, 95% CI 1.007-1.313; AUC 0.540).
Conclusions:
A simple composite score may provide pragmatic exploratory grouping of SUI risk after RARP, but discrimination is modest and interpretation is limited by non-validated outcome assessment and the absence of major confounders, including nerve-sparing status and baseline functional measures.