Robot-Assisted Laparoscopic Versus Retropubic Radical Prostatectomy: Comparison of Functional and Oncological Outcomes, A Single-Center Experience

Objective: This study aimed to investigate the effect of robot-assisted laparoscopic radical prostatectomy (RARP) and open retropubic radical prostatectomy (RRP) on perioperative functional and oncological outcomes. Materials and Methods: This single-center retrospective study analyzed data of 443 patients who had undergone radical prostatectomy (RP) with localized prostate cancer. Surgical and clinicopathologic data, oncological and functional outcomes, and complications were compared between RRP and RARP groups. The comparison was made by the Mann-Whitney U test, chi-square test, and t-test for qualitative and quantitative variables, as appropriate. Log rank test was used to determine the biochemical recurrence-free survival of both surgical methods. Kaplan-Meier analysis was performed to estimate survival rates. Results: The RRP and RARP groups included 231 and 212 patients, respectively. Blood loss, indwelling catheter duration, and hospitalization rates were low in the RARP group. Although the continence rates were better in the RARP group at 3 months, they were comparable at 12 months. In both groups, erection sufficient for sexual intercourse was comparable at 3 and 12 months. The mean lymph node yield was higher in the RRP group than in the RARP group. On median 28-month follow-up, no difference was found in the oncological results. Conclusion: Although the oncological and functional results of RRP and RARP are comparable, RARP is a more minimally invasive procedure. In our opinion, the surgeon's experience is more effective than the chosen technique.