Int Urol Nephrol. 2026 May 13. doi: 10.1007/s11255-026-05187-0. Online ahead of print.
ABSTRACT
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.
PMID:42126768 | DOI:10.1007/s11255-026-05187-0
