Surgical techniques that improve urinary continence and sexual outcomes in patients undergoing robotic prostatectomy for prostate cancer: a narrative review.
PURPOSE OF REVIEW Despite several advancements in the surgical technique of robotic prostatectomy, urinary incontinence and sexual dysfunction remain as significant side effects. The purpose of this review is to compare and evaluate the various modifications during the robotic prostatectomy that can help improve both urinary and sexual function outcomes. RECENT FINDINGS Surgical innovations such as Retzius-sparing, anatomical reconstruction, and various tissue preservation techniques demonstrate high recovery rates of urinary continence up to 90% within 12 months. However, postoperative sexual potency outcomes vary widely across techniques and remain largely influenced by preoperative patient factors. Approaches such as endopelvic fascia preservation and ultrapreservation show promising erectile recovery rates up to 80% at one year. It is reassuring that these technical modifications continue to maintain acceptable oncological safety while helping to improve functional outcomes. SUMMARY We evaluated recent surgical innovations in robotic prostatectomy that can help improve both sexual function outcomes while maintaining oncological safety. Future studies should focus on head-to-head comparisons of these anatomical techniques through well designed prospective studies to establish superiority in functional recovery after prostatectomy.