How to optimize patient selection for robot-assisted radical prostatectomy: Functional outcome analyses from a tertiary referral center

Introduction: The role of surgical approach on functional outcomes recovery in prostate cancer (PCa) patients treated with bilateral nerve-sparing radical prostatectomy (BNSRP) is still debated. In this study, we examine the association between the surgical approach and functional outcomes after BNSRP. Patients and Methods: The study included 609 patients treated with robot-assisted radical prostatectomy (RARP) or open radical prostatectomy (ORP) between June 2008 and January 2011. Erectile function recovery was defined as an International Index of Erectile Function-Erectile Function domain (IIEF-EF) score ≥22. Urinary continence recovery was defined as being completely pad-free over a 24-hour period. Patients were stratified according to their probability of postoperative erectile dysfunction and urinary incontinence, according to previously published predictive models. Multivariable logistic regression tested the association between the surgical approach and functional outcomes recovery in the overall population after stratifying patients according to their risk of erectile dysfunction and urinary incontinence. Results: Patients treated with RARP had higher 2-year erectile function (52.1% vs 67.8%; P