First 200 Retzius-Sparing Prostate Surgeries in Australia: Key Outcomes and Findings

What is it about?

This study presents the first multi-centered Australian series of 200 cases of Retzius-sparing radical prostatectomy (RSRP) conducted between April 2017 and June 2024 across five centers in Melbourne and Brisbane. The methodology involved prospective data collection with ethical approval, focusing on patients who met specific inclusion criteria, which were later relaxed as experience with the procedure increased. This study found that RSRP demonstrated improved early continence outcomes, with 91.3% pad-free at 12 months, and a positive surgical margins (PSM) rate of 14.5%. The procedure showed a complication rate of 12.5% for Clavien-Dindo grade 1-3. This study concluded that RSRP could be safely introduced by experienced minimally-invasive surgeons, providing excellent early continence and good oncological results. Concerns about higher PSM rates exist, but earlier studies suggest these may decrease with growing surgical experience. This series is significant as it provides the first comprehensive Australian data on RSRP, adding to the global body of evidence supporting the technique's benefits.

Featured Image

Why is it important?

This study is significant as it provides the first multi-centred Australian data on Retzius-sparing radical prostatectomy (RSRP), a surgical technique aimed at improving continence outcomes post-radical prostatectomy. Incontinence following prostate surgery is a major concern due to its impact on patients' quality of life. By focusing on RSRP, this research contributes valuable insights into its effectiveness and safety within an Australian context, potentially guiding future surgical practices and patient care strategies. Key Takeaways: 1. This study examines the outcomes of 200 RSRP procedures performed across multiple centers in Australia, revealing a high rate of early continence, with 91.3% of patients pad-free at 12 months post-surgery. 2. The research demonstrates that despite concerns about positive surgical margins (PSM) in RSRP, the overall PSM rate was 14.5%, which is consistent with other studies, suggesting that the technique does not compromise oncological safety when performed by experienced surgeons. 3. Findings indicate that RSRP can be safely introduced by minimally-invasive surgeons with good functional and oncological outcomes, as evidenced by the 60.4% potency rate at 12 months post-surgery in previously potent men.