Retzius-sparing pure laparoscopic radical prostatectomy: initial experience from a single surgeon
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Updated: Nov 7, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Dragan Grbic1, Alexander Cantrell2, Djordje Filipovic1
1Department of Urology, University Clinical Centre of Vojvodina, Novi Sad, Serbia.
Introduction:
Retzius-sparing radical prostatectomy (RSRP) has gained popularity in robotic surgery due to superior early urinary continence recovery relative to the conventional anterior approach to robot-assisted RP. However, data on pure RS laparoscopic RP (LRP) implementation remain limited. We present our initial experience and early urinary continence outcomes during the implementation phase of RSLRP.
Aim:
The aim of this study was to evaluate early functional and oncological outcomes of RSLRP, with particular emphasis on early continence recovery, and to assess the feasibility of this approach in centers without access to robotic technology.
Materials And Methods:
Between August 2024 and October 2025, 7 patients with localized prostate cancer (cT1c-cT2b) underwent RSLRP performed by a single surgeon. Data on perioperative parameters, pathological findings, and early continence outcomes were prospectively collected. Assessment of erectile function was excluded, since the postoperative follow-up period was insufficient.
Results:
All procedures were completed without conversion or blood transfusion. Mean (SD) operative time (from incision to closure) was 242.9 (36.84) minutes, and mean length of hospital stay was 1.86 (0.9) days. Pathological analysis showed locally advanced disease (pT3) in 42.8% of the patients. Positive surgical margins were identified in 57.1% of the cases. Biochemical recurrence occurred in 3 individuals, who received adjuvant radiotherapy and androgen deprivation therapy. All patients achieved urinary continence (completely dry or use of 1 safety-liner pad), with 42.8% achieving continence immediately after surgery, and 100% within 3 months.
Conclusions:
RSLRP is feasible and can be performed safely during the surgeon's learning curve. The early rate of continence recovery was encouraging; however, due to the high positive surgical margin rate and short follow-up, oncological outcomes must be interpreted with caution, and larger series with longer follow-up are required.