Balancing continence function and oncological outcomes during robot‐assisted radical prostatectomy (RARP)

摘要

What's known on the subject? and What does the study add? In the last decade, the desire to reduce the invasiveness of traditional open and laparoscopic surgery and, above all, the attempt of achieving better functional results, produced the increased interest in and the popularity of robotic techniques both in Europe and the USA. In the present study we reported on our original surgical technique, and our perioperative, functional and oncological results, as well as on data from the most important published studies. A critical point in the evaluation of the radical prostatectomy (RP) outcomes is whether patients who obtain good cancer control also obtain good functional results. Specifically, urinary continence recovery seems to have a more relevant impact on the patient's health‐related quality of life in comparison with potency recovery. Moreover, this functional outcome is relevant for all patients who underwent RP regardless of the execution of a nerve‐sparing approach to preserve potency. Data coming from robot‐assisted RP (RARP) series show excellent results for early and definitive urinary continence recovery and for negative surgical margins. Unfortunately, no data are available about the combination of these two relevant outcomes after RARP. In this review article, we describe our surgical technique to minimize the risk of urinary incontinence and positive surgical margins and summarize data concerning continence recovery and early oncological outcomes after RARP.