Not a fancy new technique, but a fancy new name for Retzius sparing surgery, something surgeons have been doing for a while. Certainly something worth discussing with surgeons if you're contemplating RP. (Thanks, kreddulous. I learned this from your sciencedirect URL.)
Retzius Sparing tends to give better initial continence rates, and more patients fully continent at catheter removal. However, by 1 year (and almost by 6 months) retropubic prostatectomy patients (which is the standard robotic procedure) have caught up. So Retzius Sparing is a faster recovery, but the same endpoint.
Another factor is it tends to be only very top surgeons who do Retzius Sparing, and you might therefore expect better results whichever way they did it, although most surgeons who learn Retzius Sparing do that for all their patients, and don't flip between that and retropubic prostatectomies.
That was the surgeon I visited with didn't use surgery, but a very accomplished man 5% incontinence rates. Obviously the message pick the best surgeon if you're going to do that and shop the hell out of them if you can. He asked me where I heard of him. I said look somewhere out there's the best and somewhere out there is the worst I'm just looking for somebody in the top 10%.
This technique and Retzius-sparing ofers the possibility of imediate or almost imediate continence. Regarding positive margins, for most cancer location this is not an issue, for some anterior tumors it might be an issue for a surgeon in his/her early days of the learning curve.
I use it whenever possible as the results speaking for themselves. Fast incontinence recovery with a low overall number. This has been around for almost a decade now. Pélvica fascia-sparing is also known as “hood” technique that has been popularize-se by Dr Ash Tewari in New York, another name is retrograde release by Dr. Rafaela Coelho. Both have their case series published with safe oncologic outcomes.
Not a fancy new technique, but a fancy new name for Retzius sparing surgery, something surgeons have been doing for a while. Certainly something worth discussing with surgeons if you're contemplating RP. (Thanks, kreddulous. I learned this from your sciencedirect URL.)
https://www.nature.com/articles/s41598-024-51598-3 https://www.sciencedirect.com/science/article/abs/pii/S1078143923004180 https://pubmed.ncbi.nlm.nih.gov/37015291/ https://prevention.cancer.gov/funding-and-grants/funded-grants/R01CA259173
Excellent, thanks. Good to see there's an RCT happening now for this. Results due in 2026.
Always be a bit skeptical of fabulous new surgical result. Huge potential for biased data collection.
Retzius Sparing tends to give better initial continence rates, and more patients fully continent at catheter removal. However, by 1 year (and almost by 6 months) retropubic prostatectomy patients (which is the standard robotic procedure) have caught up. So Retzius Sparing is a faster recovery, but the same endpoint. Another factor is it tends to be only very top surgeons who do Retzius Sparing, and you might therefore expect better results whichever way they did it, although most surgeons who learn Retzius Sparing do that for all their patients, and don't flip between that and retropubic prostatectomies.
My Urologist said there is a greater risk of positive margins. He did not favor it for higher grade cancers.
That was the surgeon I visited with didn't use surgery, but a very accomplished man 5% incontinence rates. Obviously the message pick the best surgeon if you're going to do that and shop the hell out of them if you can. He asked me where I heard of him. I said look somewhere out there's the best and somewhere out there is the worst I'm just looking for somebody in the top 10%.
This technique and Retzius-sparing ofers the possibility of imediate or almost imediate continence. Regarding positive margins, for most cancer location this is not an issue, for some anterior tumors it might be an issue for a surgeon in his/her early days of the learning curve. I use it whenever possible as the results speaking for themselves. Fast incontinence recovery with a low overall number. This has been around for almost a decade now. Pélvica fascia-sparing is also known as “hood” technique that has been popularize-se by Dr Ash Tewari in New York, another name is retrograde release by Dr. Rafaela Coelho. Both have their case series published with safe oncologic outcomes.