MP15-14 RETZIUS-SPARING (rsRARP) vs. CONVENTIONAL ROBOTIC ASSISTED RADICAL PROSTATECTOMY (cRARP)—A PROSPECTIVE, RANDOMISED, SINGLE BLINDED TRIAL—RESULTS OF EARLY CONTINENCE

Abstract

INTRODUCTION AND OBJECTIVE: Since the introduction of rsRARP in 2010 three prospective RCTs comparing rsRARP and cRARP have been published. To further evaluate the results published until now we conducted a prospective, randomised, single blinded trial. METHOD(S): A total of 202 men (age 64.2+/-6.9 yrs.) with localised prostate cancer (PCa) were included and randomised 1:1. Preoperative as well as one, four and twelve weeks after foley catheter removal functional parameters (continence, sexual function) were registered via validated questionnaires (ICIQ-UI SF, IPSS, IIEF-5, QoL). RESULT(S): Three months postoperative complete data sets were available for 186 patients (cRARP n=92, rsRARP n=94). Preoperative characteristics were well balanced between the two groups. Hospital stay (4.1+/-0.9 vs. 5.4+/-5.8 d; p=0.037) and console time for prostate dissection (36.8+/-8.8 vs. 46.8+/-12.8Min; p=0.017) were significantly shorter in the rsRARP-Group. Also did patients after rsRARP have a faster recovery of continence (after 1 week p=0.003, 3 months p=0.022), lower number of incontinence pads used per day (p=0.001, 0.011, 0.019 after 1, 4 and 12 weeks respectively) and a lower impairment in quality of life caused by involuntary loss of urine (p=0.001, 0.002, 0.005, 1, 4 and 12 weeks respectively). Oncological follow-up data is not yet available for this cohort. From our experience the rate of BCR after rsRARP is 5.9% (4.1% for R1- resection). CONCLUSION(S): Despite being technically more challenging rsRARP results in a significantly faster recovery of continence and lower number of incontinence pads used. Also, quality of life after a period of three months is significantly higher. Furthermore, rsRARP is associated with a good oncological outcome and a low BCR-rate.