Jim Hu, MD, on urinary continence recovery across RARP techniques

Pelvic fascia-sparing techniques (Retzius-sparing, Hood) during robotic-assisted radical prostatectomy (RARP) led to greater return of urinary continence at 3 months compared with standard RARP, according to data presented at the 2025 American Urological Association (AUA) Annual Meeting in Las Vegas, Nevada.

In a recent interview with Urology Times®, senior author Jim C. Hu, MD, MPH, walked through these findings in-depth and discussed their significance for clinical practice.

He noted, “Our study is unique, not only in our sample size of greater than 1000 patients and the fact that it's multicenter, but also the fact that that we have a comparison of these 3 different approaches.”

Hu is a urologic oncologist at Weill Cornell Medicine in New York, New York.

In total, the study included 1155 patients who underwent RARP at Weill Cornell or Georgetown. Of these, 593 patients underwent the standard approach, 332 underwent the Retzius-sparing approach, and 230 underwent the Hood approach.

Overall, data showed that the Retzius-sparing approach led to the greatest improvement in urinary incontinence scores per EPIC-CP at 3 months, 6 months, and 12 months (all, P < .001) following RARP. However, the Retzius-sparing approach also had the most positive margins at 37%, compared with 30% for the standard approach and 30% for the hood approach (P = .039).

According to Hu, these data represent the tradeoffs associated with the Retzius-sparing approach.

A randomized controlled trial is currently underway to further compare oncological and functional outcomes between these RARP techniques.

REFERENCE

1. Wald G, Suzman E, Mason JB, et al. Recovery of urinary continence after robotic-assisted radical prostatectomy: A multicenter comparison of Retzius-sparing, hood and standard techniques. J Urol. 2025;213(5S):e239. doi:10.1097/01.JU.0001109784.58660.a5.18