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Comparison of Retzius-sparing and conventional robot-assisted laparoscopic radical prostatectomy regarding continence and sexual function: an updated meta-analysis

Prostate Cancer and Prostatic Diseases volume 25, pages 47–54 (2022)Cite this article

Subjects

Abstact

Background

Studies comparing C-RARP and RS-RARP have reported different results and the choice between the two operation methods remains controversia.

Methods

We present the meta-analysis on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The meta-analysis was carried out using Review Manager 5.3 (Cochrane Collaboration, Oxford, United Kingdom) and Stata SE 14.0. The mean difference (MD) with 95% confidence intervals (CI) were used to describe the results of continuous data; odds ratio (OR) with 95% CI were used to describe dichotomous data. Statistical significance was set at P < 0.05.

Results

The meta-analysis revealed that RS-RARP had a statistically significant advantage in terms of continence recovery immediately after operation (OR: 0.40, 95% CI: 0.20–0.77; P = 0.007) (Fig. 2a), after 1 month (OR: 0.17, 95% CI: 0.10–0.29; P < 0.00001) (Fig. 2b), after 3 months (OR: 0.18, 95% CI: 0.09–0.36; P < 0.00001) (Fig. 2c), after 6 months (OR: 0.26, 95% CI: 0.15–0.46; P < 0.00001) (Fig. 2d) and after 12 months (OR: 0.50, 95% CI: 0.28–0.89; P = 0.02) (Fig. 2e).

Conclusions

This meta-analysis found that RS-RARP had better postoperative continence recovery than C-RARP, while sexual function recovery rates were not significantly different. There were also no significant differences in operation time, intraoperative blood loss, length of stay, positive margin rate and complications.

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Fig. 1
Fig. 2: Forest plot of postoperative continence between two group.
Fig. 3: Forest plot of postoperative sexual function between two group.
Fig. 4: Forest plot of postoperative secondary outcomes between two group.
Fig. 5: Funnel plot and sensitivity analysis between two group.

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Acknowledgements

This work was supported by grants from the Natural Science Foundation of Chongqing (cstc2019jcyj-msxmX0732), and Chongqing Science and Technology Commission (cstc2017shms-zdyf0319).

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Author notes

  1. These authors contributed equally: Junyan Liu, Jindong Zhang.

Authors and Affiliations

  1. Chongqing Medical University, Chongqing, 400016, China

    Junyan Liu

  2. Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

    Jindong Zhang, Qingyuan Liu, Weiyang Zhang, Zizhen Qing & Delin Wang

  3. Department of Urology, Dianjiang People’s Hospital of Chongqing, Chongqing, 408399, China

    Zongke Yang

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Contributions

JYL, JDZ and DLW contributed to the conception and design this study. ZKY, QYL, WYZ and ZZQ were responsible for the development of the methology and data interpretation. JYL, JDZ and ZKY analyzed and interpreted the data. YWX and JDZ wrote the paper. JYL, JDZ, and DLW revised the paper. JYL and JDZ contributed equally and should share first authorship. All authors read and approved the final paper.

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Correspondence to Delin Wang.

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Liu, J., Zhang, J., Yang, Z. et al. Comparison of Retzius-sparing and conventional robot-assisted laparoscopic radical prostatectomy regarding continence and sexual function: an updated meta-analysis. Prostate Cancer Prostatic Dis 25, 47–54 (2022). https://doi.org/10.1038/s41391-021-00459-5

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