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Background <p>Robot-assisted radical prostatectomy (RARP) is a widely adopted and effective treatment for localized prostate cancer. The Retzius-sparing approach (RS-RARP) has been shown to significantly improve early urinary continence recovery while maintaining comparable long-term oncological outcomes relative to the anterior approach. However, the impact of body mass index (BMI) on RS-RARP outcomes remains insufficiently investigated. The present study aimed to address this gap.</p> Methods <p>A retrospective analysis was conducted on 596 patients who underwent RS-RARP between April 2016 and December 2023, including 197 normal-weight, 287 overweight, and 112 obese individuals. Perioperative, oncological, and functional outcomes were assessed.</p> Results <p>Estimated blood loss was significantly higher in obese patients. No statistically significant differences in urinary continence rates were observed at any time point. Immediate continence rates were 77%, 72%, and 79%, while one-year continence rates were 97%, 96%, and 98% in the normal-weight, overweight, and obese groups, respectively. Oncological outcomes were comparable across groups, although a non-significant trend toward a higher rate of pN1 disease was observed in obese patients (12% vs. 10% vs. 8%, <i>p</i> = 0.1). RS-RARP was found to be feasible and safe across all BMI categories.</p> Conclusions <p>The current study suggests that RS-RARP portends optimal early and one-year urinary continence recovery rates, regardless of BMI. No statistically significant differences were noted regarding safety and oncological outcomes among the three BMI categories.</p>

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Perioperative and clinical outcomes in patients undergoing Retzius-sparing robot assisted radical prostatectomy stratified by the degree of obesity

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月13日

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  • Karen Fransis,
  • Stefano Tappero,
  • Stephanie Dautricourt,
  • Christophe De Laet,
  • Stefan De Wachter,
  • Piet Dirix,
  • Gunter De Win

摘要

Background

Robot-assisted radical prostatectomy (RARP) is a widely adopted and effective treatment for localized prostate cancer. The Retzius-sparing approach (RS-RARP) has been shown to significantly improve early urinary continence recovery while maintaining comparable long-term oncological outcomes relative to the anterior approach. However, the impact of body mass index (BMI) on RS-RARP outcomes remains insufficiently investigated. The present study aimed to address this gap.

Methods

A retrospective analysis was conducted on 596 patients who underwent RS-RARP between April 2016 and December 2023, including 197 normal-weight, 287 overweight, and 112 obese individuals. Perioperative, oncological, and functional outcomes were assessed.

Results

Estimated blood loss was significantly higher in obese patients. No statistically significant differences in urinary continence rates were observed at any time point. Immediate continence rates were 77%, 72%, and 79%, while one-year continence rates were 97%, 96%, and 98% in the normal-weight, overweight, and obese groups, respectively. Oncological outcomes were comparable across groups, although a non-significant trend toward a higher rate of pN1 disease was observed in obese patients (12% vs. 10% vs. 8%, p = 0.1). RS-RARP was found to be feasible and safe across all BMI categories.

Conclusions

The current study suggests that RS-RARP portends optimal early and one-year urinary continence recovery rates, regardless of BMI. No statistically significant differences were noted regarding safety and oncological outcomes among the three BMI categories.