The impact of prostate size on single port robot-assisted radical prostatectomy surgical outcomes
Recommended Citation
Finocchiaro A, Aljoulani M, Almajedi M, Viganó S, Bertini A, Biasatti A, Valenzi F, Ficarra V, Sorce G, Salonia A, Briganti A, Montorsi F, Lughezzani G, Buffi NM, Vourganti S, Autorino R, Crivellaro S, Nelson R, Rogers C, Abdollah F. The impact of prostate size on single port robot-assisted radical prostatectomy surgical outcomes. Eur Urol 2026; 89:1.
Document Type
Conference Proceeding
Publication Date
3-1-2026
Publication Title
Eur Urol
Keywords
Urology & Nephrology
Abstract
OBJECTIVE: To evaluate the effect of prostate size on surgical outcomes in single-port robot-assisted radical prostatectomy (SP-RARP). PATIENTS AND METHODS: We conducted a multicentre analysis of patients undergoing SP-RARP between 2018 and 2024. Our primary endpoint was to assess the impact of prostate size on SP-RARP surgical outcomes, including operating time, estimated blood loss (EBL), nerve-sparing status, margin status, and intra-/postoperative complications. Logistic regression models assessed the independent impact of prostate size (calculated at final pathology) on these outcomes. RESULTS: A total of 343 patients were included; the median (interquartile range) prostate size was 46 (37-52) g. Of these, 114 patients had a prostate size of /=70 g. Larger prostates were associated with significantly prolonged operating time (265 vs 301 vs 306 min, P < 0.001), increased EBL (100 vs 100 vs 150 mL, P = 0.012), and lower nerve-sparing rates (79% vs 64% vs 44%, P < 0.001). Non-focal positive margins occurred in 23% of cases, with no significant differences across size groups (P = 0.6), nor for intraoperative (P = 0.2) or for postoperative complications (P > 0.9) rates between prostate size groups. In multivariable logistic regression, prostate size remained an independent predictor of prolonged operating time above median (P = 0.012), increased EBL above median (P = 0.007), and lower nerve-sparing (P = 0.002). No significant association was found with margin status (P = 0.092) or postoperative complications (P > 0.9). CONCLUSIONS: Prostate size impacts intraoperative complexity in SP-RARP but does not increase complication or margin rates. These findings support the feasibility and safety of SP-RARP across a broad range of prostate sizes, consistent with trends reported for multiport RARP.
Volume
89
First Page
1
