Related Experiment Video
Updated: Sep 14, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Early continence and postoperative urodynamic findings after single-port transvesical robot-assisted radical
Kwang Jin Ko1, Jae Hoon Chung2
1Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Background:
Single-port transvesical robot-assisted radical prostatectomy (SP-TVRP), which enables early continence outcomes, has recently emerged. This study aimed to describe objective postoperative urodynamic findings at 3 months after SP-TVRP and to determine whether these findings are compatible with early continence recovery in a preliminary prospective physiologic case series.
Methods:
This prospective single-center, single-surgeon case series enrolled 11 patients who underwent SP-TVRP for prostate cancer without radiologic nodal or distant metastasis. All patients completed validated functional questionnaires and underwent comprehensive urodynamic study (UDS) at 3 months postoperatively.
Results:
Postoperative UDS showed a favorable storage profile, with a median maximum cystometric capacity (MCC) of 450 mL and median bladder compliance of 64 mL/cmH2O. Median bladder outlet obstruction index (BOOI) and bladder contractility index (BCI) values were 16 and 93, respectively. After correction for intravesical-pressure drift during urethral pressure (Pura) profilometry, functional urethral length (FUL) estimates ranged from ≤1 cm to approximately 2.4 cm. Abdominal leak point pressure (ALPP) testing showed no provoked leakage in 72.7% of patients. Zero-pad continence rates were 36.4%, 54.5%, and 90.9% immediately after catheter removal, at 1 month, and at 3 months, respectively, and the 3-month 0-1 safety-pad rate was 100%. The positive surgical margin rate was 45.5%, and prostate-specific antigen (PSA) persistence occurred in 18.2% of patients, emphasizing important oncologic limitations in this initial experience.
Conclusions:
In this preliminary physiologic case series, 3-month postoperative UDS findings were compatible with favorable early continence recovery after SP-TVRP. However, because preoperative UDS and a control group were not available, these data cannot establish true preservation, improvement, or superiority of continence mechanisms. The high positive surgical margin rate and PSA persistence require cautious interpretation, careful patient selection, and longer oncologic follow-up before SP-TVRP can be considered broadly applicable.