Application and efficacy of Retzius-sparing robotic-assisted radical prostatectomy

Background and objective The results of comparing standard Robotic-assisted Radical Prostatectomy (S-RARP) and Retzius-sparing Robotic-assisted Radical Prostatectomy (RS-RARP) in treating early urinary continence (UC), oncological outcomes, operation time, and perioperative morbidity in patients with clinically localized prostate cancer were analyzed. Methods A retrospective analysis was conducted on the clinical data of 120 cases of RS-RARP performed at the First Affiliated Hospital of Gannan Medical University from October 2019 to March 2025. Among them, 60 cases underwent standard Robotic-assisted Radical Prostatectomy (S-RARP), and 60 cases underwent Retzius-sparing Robotic-assisted Radical Prostatectomy (RS-RARP). The clinical data, perioperative indicators, and surgical outcomes of the two groups of patients were compared. Results All 120 surgeries were successfully completed. The operation time (mean ± SD) of the S-RARP group was (138.97 ± 47.24) minutes, and that of the RS-RARP group was (150.78 ± 51.72) minutes. There was no statistically significant difference ( P > 0.05). The intraoperative blood loss (IQR) of the S-RARP group was 100.00 (237.50) mL, and the incidence of perioperative complications was 8.33% (5/60); for the RS-RARP group, it was 100.00 (150.00) mL and 6.67% (4/60), and the differences between the two groups were not statistically significant (all P > 0.05). The positive rate of surgical margins in the S-RARP group was 30% (18/60), and that in the RS-RARP group was 35% (21/60), and the difference was not statistically significant ( P > 0.05). Comparisons of the immediate, first-week, and first-month urinary continence recovery rates between the two groups showed that the RS-RARP group was superior to the S-RARP group, and the differences were statistically significant (all P < 0.01); however, the third-month urinary continence recovery rate showed no statistically significant difference ( P = 0.057). Conclusions Retzius-sparing Robotic-assisted Radical Prostatectomy is beneficial for improving the early recovery of urinary incontinence in patients.