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Updated: Jun 13, 2026

Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
High-Intensity Focused Ultrasound Versus Robot-Assisted Radical Prostatectomy for Localized Prostate Cancer: A
Si Ge1, Zhiqiang Zeng2, Lei Zheng3
1Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, China. gesi822927@126.com.
Background:
This study aimed to compare functional and oncologic outcomes between high-intensity focused ultrasound (HIFU) and robot-assisted radical prostatectomy (RARP) for patients with localized prostate cancer (LPCa).
Methods:
Four databases (Embase, PubMed, Cochrane Library, Web of Science) were systematically searched from inception to December 2025. The review followed PRISMA 2020 and AMSTAR 2 guidelines. Pooled effect estimates were calculated using Stata 17. Random-effects models were applied when I2 was 50 % or higher or the P value was lower than 0.10.
Results:
Five cohort studies (n = 2123) were included. In this review, HIFU was associated with significantly higher International Index of Etile Function (IIEF)-5 scores at 6 months (effect, 3.41; 95 % confidence interval [Cl], 1.88-4.94; P < 0.05), 12 months (effect, 3.75; 95% Cl 3.00-4.49; P < 0.05), and 24 months (effect, 2.72; 95% Cl 0.59-4.85; P < 0.05). Urinary continence overy also favored HIFU (odds ratio [OR], 0.40; 95% Cl 0.27-0.59; P < 0.05) for pad-free rates at baseline and at 6 and 12 months (all P < 0.05). No significant differences were observed in International Prostate Symptom Score (IPSS) or salvage therapy rates.
Conclusion:
For patients with localized prostate cancer, HIFU offers better etile function and urinary continence overy than RARP, with comparable complication and salvage therapy rates. Long-term oncologic outcomes remain to be confirmed.

