Impact of Anterior Urethral Suspension Combined With Pelvic Fascia Reconstruction During Robot-Assisted Radical Prostatectomy on Early Postoperative Urinary Continence Recovery: A Single-Center, Prospective, Single-Arm Clinical Study (IAPREA)

This single-center prospective cohort study will enroll patients with localized and locally advanced prostate cancer at The Cancer Hospital of the Chinese Academy of Medical Sciences from December 2025 to July 2026. All participants will undergo modified robot-assisted radical prostatectomy combining anterior urethral suspension and pelvic fascia reconstruction. Eligible patients are aged 40-75 years with pathologically confirmed T2-T3 prostate cancer, candidates for robotic radical prostatectomy, complete clinical and imaging data, willingness to attend regular follow-up, and signed written informed consent. Exclusion criteria include prior pelvic radiotherapy or prostate surgery, severe organ dysfunction incompatible with general anesthesia, preoperative neurogenic bladder or persistent urinary incontinence, and refusal to complete the full follow-up schedule. All surgeries will be performed by the same senior urologist following standardized protocols. The core modified technique consists of anterior urethral suspension combined with pelvic fascia reconstruction to facilitate early postoperative urinary continence recovery; urinary continence is defined as using no more than one absorbent pad per day. Intraoperative blood loss and operative duration will be fully documented in real time. Patients will receive telephone follow-up at 1, 2 and 3 months postoperatively. Urinary continence status will be assessed at each contact, and serum PSA testing will be performed regularly to monitor biochemical recurrence, which is defined as sustained PSA levels exceeding 0.1 ng/mL. All perioperative and long-term postoperative complications will be documented in detail. All clinical data will be entered into a standardized electronic database for statistical analyses. The primary endpoint is the rate of urinary continence recovery at 3 months after surgery, while secondary endpoints cover the oncological safety and perioperative risks of the modified procedure. This study aims to verify whether this improved surgical technique can achieve a favorable balance between postoperative urinary functional recovery and oncological tumor control.