Robot-Assisted Radical Prostatectomy: the HOOD Technique Versus Standard Anterior Reconstruction

Early Functional Outcomes After Robot-Assisted Radical Prostatectomy: A Prospective Comparison of the HOOD Technique Versus Standard Anterior Reconstruction

This prospective, non-randomized cohort study included consecutive patients undergoing robotic-assisted laparoscopic radical prostatectomy (RARP) between January 2024 and January 2026 following ethics committee approval. Patients with clinically localized prostate cancer eligible for bilateral nerve-sparing surgery were enrolled. Two surgical techniques-anterior-posterior reconstruction (APR) and the HOOD technique-were compared. All procedures were performed by a single high-volume surgeon at a tertiary referral center. The primary endpoint was early urinary continence recovery, assessed at catheter removal and at 3, 6, and 12 weeks postoperatively. Secondary outcomes included postoperative complications, positive surgical margin rates, and early oncological outcomes.

Inclusion Criteria:

• life expectancy >10 years,
• clinically organ confined disease (cT1-cT2),
• biopsy ISUP GG ≤3,
• total serum prostate-specific antigen (PSA) ≤10 ng/ml
• normal preoperative continence and potency

Exclusion Criteria:

• high risk prosatate cancer
• cN1
• M1 prostate cancer (according to preoperative GA68 PSMA PET CT)
• pre-existing urinary incontinence,
• previous prostatic, urethral, bladder neck surgery
• neoadjuvant therapy
• prior pelvic radiotherapy