Continence Post Retzius-Sparing Versus Standard Robot-Assisted Radical Prostatectomy (Continence)

November 6, 2026 updated by: Mohammed Hassan Ahmed Aly, Armed Forces College of Medicine, Cairo, Egypt

Retzius-Sparing Versus Standard Robot-Assisted Radical Prostatectomy: A Prospective Randomized Comparison on Immediate Continence Rates Using Versius Robotic System

To compare the short term (three month) continence rates using versius robotic system between the Retzius-sparing and the standard RARP within three month from removal of catheter.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Prostate cancer has the highest incidence rate and second highest mortality rate among cancers in men, accounting for a significant portion of new cancer diagnoses and cancer-related deaths.

Robot-Assisted Radical Prostatectomy (RARP) has become a standard treatment for localized prostate cancer, offering advantages such as reduced blood loss, shorter hospital stays, and quicker recovery compared to traditional open surgery. The use of advanced robotic platforms, including the Versius robotic system, has significantly improved precision in prostatectomy procedures.

Urinary continence remains one of the most important functional outcomes for patients undergoing radical prostatectomy. Despite advances in surgical techniques, many patients experience transient postoperative incontinence, which significantly impacts quality of life. The preservation of the puboprostatic ligaments and anterior bladder structures during surgery has been identified as a key factor in reducing the risk of incontinence.

Radical prostatectomy can be performed open, laparoscopically, or robot-assisted. Minimally invasive radical prostatectomy has become more common, utilizing two primary approaches for RARP: the standard/anterior approach and the Retzius-sparing/posterior approach (RS-RARP). In RS-RARP, the prostate is removed entirely through the rectovesical space, resulting in the preservation of all structures in the Retzius space and leading to major improvements in functional outcomes, particularly immediate continence recovery.

Urinary incontinence remains one of the main risks following radical prostatectomy regardless of the surgical technique used. Incontinence rates can vary depending on the assessment questionnaires utilized, such as the University of California Los Angeles Prostate Cancer Index (UCLA-PCI). Total urinary continence after catheter removal increases progressively over time.

Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) is reported to be associated with better immediate continence compared to the standard anterior approach, with no differences observed in longer-term functional recovery, quality of life, or other key outcomes. Furthermore, potency and serious complication rates appear comparable, showing no significant differences in the preservation of erectile function or overall postoperative complication rates between the two techniques.

Study Type

Interventional

Enrollment (Actual)

88

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Cairo, Egypt
        • Urology Department, Kasr Al-Ainy school of medicine,Cairo University
    • Cairo Governorate
      • Cairo, Cairo Governorate, Egypt
        • Armed Forces College of Medicine , Cairo, Egypt.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

Male

Description

Inclusion Criteria:

  • Clinical Stage: Clinical T1-3 N0 M0 prostate cancer.
  • Prostate Size: Less than 100 gm.

Exclusion Criteria:

  • Patients refusing Surgery.
  • Patients unfit for surgery.
  • History of previous TURP.
  • Salvage Prostatectomy.
  • Post Biopsy Febrile Prostatitis.
  • Patients with retention and voiding dysfunction.
  • Body mass index > 40

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Retzius-Sparing Robot-Assisted Radical Prostatectomy (RS-RARP)

Patients undergo Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) using the Versius robotic system.
Procedure: Procedure: Retzius-Sparing Robot-Assisted Radical Prostatectomy (RS-RARP)

Patients undergo Retzius-sparing (posterior) robot-assisted radical prostatectomy using the Versius robotic system, where the prostate is removed entirely through the rectovesical space, resulting in the preservation of all structures in the Retzius space.

Other Names:
  • Retzius-sparing (posterior) robot-assisted radical prostatectomy
Active Comparator: Standard Robot-Assisted Radical Prostatectomy (S-RARP)

Patients undergo standard (anterior) robot-assisted radical prostatectomy (S-RARP) using the Versius robotic system.
Procedure: Standard Robot-Assisted Radical Prostatectomy (S-RARP)

Patients undergo standard (anterior) robot-assisted radical prostatectomy using the Versius robotic system through Retzius space

Other Names:
  • standard (anterior) robot-assisted radical prostatectomy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Urinary Continence (0-1 pads/day)
Time Frame: 1 week after catheter removal

The proportion of patients who achieve urinary continence (defined as the need for 0-1 pad per day) within a specified postoperative period e.g., 7 days or 30 days or 3 months.
1 week after catheter removal

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Continence at 1 and 3 months
Time Frame: 1 and 3 months after catheter removal

ICIQ-UI score at 1 month and 3 months after catheter removal
1 and 3 months after catheter removal
Assessing positive surgical margins
Time Frame: 1 week and 3 months

Assessment of PSMs postoperatively to assess the oncological outcomes and assessment of PSA level at 3 months
1 week and 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Armed Forces College of Medicine, Cairo, Egypt

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 6, 2025

Primary Completion (Actual)

July 1, 2026

Study Completion (Actual)

September 30, 2026

Study Registration Dates

First Submitted

October 12, 2026

First Submitted That Met QC Criteria

October 26, 2026

First Posted (Actual)

October 27, 2026

Study Record Updates

Last Update Posted (Actual)

November 12, 2026

Last Update Submitted That Met QC Criteria

November 6, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Robotic Radical Prostatectomy

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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