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Comparative Study
. 2025 Aug;57(8):2435-2443.
doi: 10.1007/s11255-025-04423-3. Epub 2025 Feb 19.

A comparative analysis of robotic prostatectomy techniques post TURP/HOLEP: retzius-sparing vs. non-retzius approaches: evaluation of perioperative, functional, and oncological outcomes

Atanu Kumar Pal  1 , Jeni Mathew  1 , Sandeep Prabhakaran  1 , T A Kishore  2
Affiliations
Comparative Study

A comparative analysis of robotic prostatectomy techniques post TURP/HOLEP: retzius-sparing vs. non-retzius approaches: evaluation of perioperative, functional, and oncological outcomes

Atanu Kumar Pal et al. Int Urol Nephrol. 2025 Aug.

Abstract

Purpose: We evaluated the perioperative, functional, and oncological outcomes of Retzius-sparing and conventional non-Retzius-sparing robotic radical prostatectomy (RS-RARP and NRS-RARP) in the patients with a prior history of transurethral resection and enucleation of prostate (Post TURP/HOLEP).

Methods: A total of 47 patients who had at least completed one year of follow-up after robotic radical prostatectomy and had a prior TURP/HOLEP were included in this retrospective analysis. The clinico-demographic data, perioperative parameters such as mean operating time, blood loss, mean hospital stay, complications as per Clavien-Dindo grading, and readmission were evaluated. Continence, potency, and biochemical recurrence were assessed to check the functional and oncological outcomes.

Results: There was no significant difference in mean age, body mass index (BMI), co-morbidities, D-Amico risk stratification, preoperative PSA level and positive cores in TRUS-guided biopsy. The console time and blood loss were significantly less in the RS-RARP group (91.6 ± 24.2 vs. 128.9 ± 38.7 min vs. 110.3 ± 57.5 vs. 152.9 ± 64.9 ml, p = 0.0002 and p = 0.02, respectively). The complication rate, mean postoperative catheter duration, lymph nodes, readmission rates, final histopathology, and invasion status were similar in both groups. Continence achieved at 1,3,6,9 and 12-month follow-up was significantly more in the RS-RARP group (90% vs. 64.7% at 12-month; p = 0.01). The potency rates in nerve-sparing cases at 6-month and 1-year follow-ups were similar. Margin positivity rates and Biochemical recurrence were comparable and statistically insignificant in both groups.

Conclusion: Retzius-sparing RARP had less console time, less intraoperative blood loss and better continence recovery in both immediate and at 12-month follow-up. The potency, biochemical recurrence and margin status in both approaches were similar.

Keywords: Non-retzius-sparing robotic radical prostatectomy; Post-HOLEP; Post-TURP; Retzius-sparing robotic radical prostatectomy; Robotic radical prostatectomy.

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Conflict of interest statement

Declarations. Conflict of Interest: The authors declare that they have no conflict of interest.

References

    1. Bhat SA, Rather SA, Islam N (2022) An overview of benign prostatic hyperplasia and its appreciation in Greco-Arab (Unani) system of medicine. Asian J Urol. https://doi.org/10.1016/j.ajur.2021.05.008 - DOI - PubMed - PMC
    1. Perera M, Lawrentschuk N, Perera N, Bolton D, Clouston D (2016) Incidental prostate cancer in transurethral resection of prostate specimens in men aged up to 65 years. Prostate Intern. https://doi.org/10.1016/j.prnil.2015.10.016 - DOI
    1. Rosenhammer B, Lausenmeyer EM, Mayr R, Burger M, Eichelberg C (2018) HoLEP provides a higher prostate cancer detection rate compared to bipolar TURP: a matched-pair analysis. World J Urol 36(12):2035–2041. https://doi.org/10.1007/s00345-018-2353-0 . (Epub 2018 Jun 1 PMID: 29858700) - DOI - PubMed
    1. Herlemann A, Wegner K, Roosen A, Buchner A, Weinhold P, Bachmann A, Stief CG, Gratzke C, Magistro G (2017) Finding the needle in a haystack”: oncologic evaluation of patients treated for LUTS with holmium laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP). World J Urol 35(11):1777–1782. https://doi.org/10.1007/s00345-017-2048-y . (Epub 2017 May 17 PMID: 28516315) - DOI - PubMed
    1. Gupta NP, Singh P, Nayyar R (2011) Outcomes of robot-assisted radical prostatectomy in men with previous transurethral resection of prostate. BJU Int 108(9):1501–1505. https://doi.org/10.1111/j.1464-410X.2011.10113.x . (Epub 2011 Mar 10 PMID: 21392223) - DOI - PubMed

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