Impact of Robot-assisted Radical Prostatectomy Technique on Short-term Continence Recovery

Traditionally, RARP is performed using a trans-peritoneal technique that pass anteriorly to
the bladder. This technique necessitates the dissection and/or manipulation of many
structures, which might compromise post-operative urinary continence recovery. These
structures include the pubo-prostatic ligament, Santorini plexus, neurovascular bundle, and
veil of Aphrodite. Recently, a "Retzius-sparing" technique to perform RARP has beed
described. This approach passes posteriorly to the bladder, through the space of Douglas,
which should minimize the damaged to the aforementioned structure. Theoretically, the latter
technique should improve post-operative urinary continence recovery. However, a randomized
comparison between the "traditional" RARP and "Retzius-sparing" RARP is still lacking.

Inclusion Criteria:

- All patients with newly diagnosed prostate cancer undergoing robotic-assisted radical
prostatectomy at the Vattikuti Urology Institute (performed by single surgeon, MM) as
the primary treatment modality

- Be able to read and speak English and be able to provide written informed consent

Exclusion Criteria:

- patients with high risk prostate cancer,defined as a biopsy Gleason score ≥8 and/or a
pre-operative prostate specific antigen value ≥20 ng/ml.

- evidence of clinical nodal involvement (cN1) or metastatic disease (M1)

- patients participating in a competing study

- patients with pre-operative urinary incontinence.