Global research trends in sexual function outcomes after robot-assisted radical prostatectomy: a bibliometric and...

Robot-assisted surgery has been widely adopted in urology, particularly as the mainstream approach for radical prostatectomy. Despite the advantages of robotic systems in surgical precision and complication control, postoperative sexual dysfunction-mainly erectile dysfunction-remains a core issue affecting patients' quality of life. Currently, a systematic visualization analysis of research trends and the intellectual structure of this topic is lacking. Therefore, this study uses bibliometric methods based on the Web of Science Core Collection to delineate the global research landscape, evolving hotspots, and emerging frontiers in the association between robot-assisted radical prostatectomy and sexual function outcomes, aiming to provide references for clinical practice and future research. We retrieved literature from the Web of Science Core Collection on the association between robot-assisted radical prostatectomy and postoperative sexual function outcomes, covering the period from 2007 to 2025. Subsequently, a series of bibliometric and visualization analyses were performed using CiteSpace (version 6.4.R1), VOSviewer (version 1.6.20), and the Bibliometrix R package (version 5.0). CiteSpace was primarily employed for country collaboration network analysis; VOSviewer was mainly used to construct keyword co-occurrence networks and journal co-citation networks; and the Bibliometrix R package was applied to generate global country collaboration world maps and to conduct annual publication output analyses. A total of 218 eligible publications were included in this bibliometric analysis, involving 1,320 authors, 414 institutions, and 39 countries, published across 73 journals and citing 3,941 references. Annual publication output fluctuated over the study period (2007-2025) but displayed a consistent upward trajectory, peaking in 2024. The United States led all countries in both publication volume (77 papers) and total citations (3,399), followed by Italy, Japan, and South Korea, while Australia achieved the highest average citations per paper. The United States also served as the central hub in the international collaboration network, with Europe and North America remaining the core research regions and Asian countries showing steadily growing contributions. Regarding institutional contributions, the most productive institutions were primarily concentrated in the United States, followed by Europe and Asia. European Urology emerged as the most influential journal in terms of total citations and average citations per article, and occupied a central position within the co-citation network. Menon, Mani, and Montorsi, Francesco were the most prolific authors, while Honda, Masashi achieved the highest average citations per article. Keyword co-occurrence analysis revealed three major research clusters: foundational surgical techniques, postoperative urinary and sexual function outcomes with comparative studies, and nerve-sparing techniques with quality of life assessments. Erectile dysfunction and urinary incontinence emerged as the most prominent outcome-specific terms, confirming their dominant positions as the primary functional outcomes of concern, while penile rehabilitation and urinary continence also appeared with lower frequencies. Co-citation analysis identified the systematic reviews by Ficarra V et al. (2012) as the most highly cited references, and the co-citation network was categorized into three major research lineages: oncologic outcomes, functional health-related quality of life, and surgical safety with comprehensive outcome assessment. This study presents the first bibliometric and visualization analysis of the literature on sexual function outcomes after robot-assisted radical prostatectomy (RARP) using the Web of Science Core Collection (2007-2025). The findings reveal a steady increase in annual publication output, with a peak observed in 2024, indicating growing global research attention to this topic. The United States emerged as the dominant contributor in terms of both publication volume and citation impact, followed by Italy and other European and Asian countries. European Urology was identified as the most influential journal, while the systematic reviews by Ficarra V et al. (2012) constituted the intellectual cornerstone of the co-citation network. Keyword analysis demonstrated that research hotspots have progressively shifted from early descriptions of surgical complications toward robotic technique optimization, nerve-sparing, functional recovery, and quality of life assessment. Notably, erectile dysfunction and urinary incontinence were the most prominent outcome-specific terms, reflecting their clinical significance as primary concerns after RARP. Despite the leadership of a small group of high-impact authors and institutions, international collaborative research remains insufficient, particularly across regions.Key limitations include database and language restrictions, citation and synonym biases, author/institution disambiguation challenges, and the inherent inability of bibliometric methods to assess clinical evidence quality. Future research should prioritize multicenter prospective studies, standardized patient-reported outcome measures, and strengthened cross-regional and interdisciplinary collaboration to advance individualized functional preservation strategies.