With the advent of robotic-assisted laparoscopic radical prostatectomy (RALP), there is great interest in the functional outcomes associated with quality of life of patient. However, the technique during surgery remains controversial. In this study, we investigate the clinical efficacy of postoperative urinary continence of endopelvic fascia preservation technique in RALP.

This study used data from the Seoul National University Prospectively Enrolled Registry for Prostate Cancer-Radical Prostatectomy (SUPER-PC-RP). From March 2016 to May 2022, patients who performed RALP were included in this study. We performed retrospective chart review and operation video analysis of patients who underwent endopelvic preservation technique during RALP to investigate surgical outcomes, postoperative complications, and oncological outcomes.

Of the 2141 patients, 224 patients were excluded for following reasons; initial radiation therapy 1, initial hormone therapy 208, and incomplete medical record 15. 1599 patients (83.4%) received endopelvic fascia open technique during RALP, and 318 patients (16.6%) received endopelvic fascia preservation technique during RALP. Median follow up period was 23.6 months. There was a statistically significant difference in operation time, console time, surgical margin rate. Endopelvic preservation was an independent predictor of 2 weeks, 3 months, 6 months social continence, and 2 weeks, 3 months pad 0 continence. There was no significant difference between the two groups in biochemical recurrence (BCR).

Endopelvic fascia preservation technique during RALP is independent predictor for 2 weeks, 3 month, and 6 month social continence and 2 week, and 3 month pad 0 continence. In addition, this method was no significant difference from endopelvic fascia open technique in BCR. However, a further-well designed study, larger scale, multicenter, and randomized controlled, is needed.