Continence recovery after robotic-assisted radical Retzius-sparing prostatectomy

Mammaev R.U., Safiullin R.I., Shatylko T.V., Gamidov S.I., Rodin I.M., Myagkova V.D., Popova A.Y.

1) National Medical Research Center for Obstetrics, Gynecology, and Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; 3) Russian Biotechnological University, Moscow, Russia; 4) Almazov National Medical Research Center of the Ministry of Health of the Russian Federation; Saint-Petersburg, Russia

Objective. To assess time to urinary continence recovery after Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) and to describe early perioperative and oncological outcomes.
Materials and methods. A retrospective analysis was performed of patients who underwent RS-RARP in 2022–2024. The primary endpoint was time to complete urinary continence (0 pads/day). Time-to-event analysis (continence recovery) was carried out using the Kaplan–Meier method, with cumulative event probability visualized as (1−S(t)) and 95% confidence intervals calculated.
Results. A total of 344 patients were included. On day 1 after urethral catheter removal, complete continence was observed in 90,1% of patients (0–1 pad/day in 97,3%). Complete continence rates were 92,1% at 1 month and 97,2% at 12 months. Mean time to continence recovery was 0,7 months (95% CI 0,428–0,973). Positive surgical margins were detected in 9% of cases; no biochemical recurrence was recorded during follow-up. Mean operative time was 113 min and mean blood loss was 121 mL.
Conclusions. RS-RARP provides rapid recovery of urinary continence with high early complete continence rates and acceptable perioperative and short-term oncological outcomes. Comparative studies versus standard RARP and comprehensive analyses of oncological and functional outcomes are needed to further clarify the advantages and limitations of this technique.

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About the Authors

Corresponding author: R.U. Mammaev – postgrad. student of the Obstetrics, Gynecology, Perinatology and Reproductive Medicine Dept., I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of the Russian Federation; Urologist of the Andrology and Urology Division, FSBSI National Medical Research Center for Obstetrics, Gynecology and Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation; Moscow, Russia; e-mail: ramazan.mammaev@outlook.com

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