Retzius-sparing robotic prostate surgery can be an excellent option for some men with prostate cancer, but it is not suitable for everyone. This is one of the most important points to understand before comparing surgical techniques. The name may sound advanced, but the right operation should never be chosen based on the technique name alone.
Retzius-sparing surgery is a specialised form of robot-assisted radical prostatectomy. It removes your prostate through a posterior approach, which means the surgeon reaches the prostate from behind rather than from the front. The aim is to preserve the space of Retzius and important pelvic support structures that may help support earlier urinary continence recovery.
Research suggests that Retzius-sparing robotic prostatectomy can help selected patients recover urinary control earlier than conventional robotic prostatectomy. However, some studies also highlight the need for careful selection because of concerns such as positive surgical margins in certain tumour locations. A 2025 meta-analysis found faster continence recovery with Retzius-sparing surgery, while also noting a tendency towards higher positive margin rates in some patients.
So, the real question is not simply, “Is Retzius-sparing surgery better?” The more important question is whether it is suitable and safe for your cancer, your anatomy, and your priorities. A specialist assessment can help you understand whether this approach is the right choice in your individual case.
What Is Retzius-Sparing Robotic Prostate Surgery?
Retzius-sparing robotic prostate surgery is a type of robot-assisted radical prostatectomy. A radical prostatectomy means your prostate gland is removed to treat prostate cancer. After this, your bladder is reconnected to the urethra, which carries urine out of your body.
In conventional robotic prostate surgery, your surgeon usually approaches the prostate from the front of the pelvis. This involves entering the space of Retzius. This area sits close to important support structures for the bladder and urethra.
In Retzius-sparing surgery, your surgeon approaches the prostate from behind instead. This helps preserve the front support space as much as possible. A 2023 review describes this technique as a posterior approach developed to improve urinary continence recovery after prostate cancer surgery.
Why Patient Suitability Matters
Retzius-sparing surgery is not chosen only because it may improve early urinary control. Cancer safety still comes first. Your surgeon must decide whether the prostate cancer can be removed properly through this approach.
They will look at where the tumour is, how aggressive it appears, and whether it is close to the edge of the prostate. They may also consider whether lymph nodes need to be removed and whether nerve-sparing is possible. These details can strongly affect the safest treatment choice.
This is why two patients with prostate cancer may receive different recommendations. One may be suitable for Retzius-sparing surgery, while another may be safer with conventional robotic surgery. Another patient may be better suited to radiotherapy or active surveillance. Suitability is personal. It depends on the cancer, the patient’s anatomy, and overall health. It should never be based only on the surgical technique itself.
Men With Localised Prostate Cancer May Be Considered
Retzius-sparing robotic prostate surgery may be considered for men whose prostate cancer is suitable for surgical removal. This usually means the cancer is thought to be confined to the prostate. It may also be considered suitable for surgical removal after specialist assessment.
Your surgeon will review your PSA level, MRI scan, biopsy results, cancer grade, staging, prostate size, urinary symptoms, general health, and personal priorities. These details help decide whether surgery is safe and appropriate. They also help show whether the posterior route can remove the cancer properly.
If the cancer appears suitable for surgery and can be safely removed using the posterior route, Retzius-sparing surgery may be discussed. However, this does not mean every man with localised prostate cancer is automatically suitable. The exact tumour position and surgical access still matter.
Tumour Location Is One of the Biggest Factors
Tumour location is very important when deciding whether Retzius-sparing surgery is suitable for you. If the cancer is towards the back of the prostate, the posterior approach may be more suitable in some cases. If the cancer is towards the front, known as an anterior tumour, your surgeon may need to be more cautious.
A study found that Retzius-sparing robotic prostatectomy was linked with a higher positive surgical margin rate in anterior tumours. This difference was not seen in posterior tumours when compared with conventional anterior robotic prostatectomy. This makes tumour position an important part of surgical planning.
This does not mean every anterior tumour rules out Retzius-sparing surgery. It means anterior tumour location needs careful discussion before a decision is made. Cancer control must always remain the priority when choosing the safest surgical approach for you.
MRI Findings Help Guide Suitability
Your MRI scan can play a major role in deciding whether Retzius-sparing surgery is appropriate. It helps show where the tumour is, how close it may be to the edge of the prostate, and whether there are suspicious areas near the capsule. These details can directly affect surgical planning.
Tumour location seen on preoperative MRI has been described as an independent predictor of positive surgical margin status after Retzius-sparing robotic prostatectomy. In plain language, this means the MRI is not only used to confirm cancer. It also helps your surgeon judge whether the Retzius-sparing route is safe and sensible for your case.
If your MRI suggests the tumour is in a difficult position, your surgeon may recommend conventional robotic surgery instead. This does not mean one option is automatically better than the other. It means the surgical plan should be chosen around your cancer location, anatomy, and safest route for removal.
Cancer Grade and Risk Level Matter
Your biopsy results also matter when deciding whether Retzius-sparing surgery is suitable. The biopsy shows how aggressive the cancer cells look under the microscope. This helps your team understand whether the cancer is low, intermediate, or higher risk.
If the cancer is higher risk, your surgeon may need to remove tissue more widely. This is done to reduce the chance of leaving cancer behind. Wider cancer clearance may affect whether Retzius-sparing surgery is recommended.
Some experienced centres do perform Retzius-sparing surgery in carefully selected higher-risk cases. However, evidence in high-risk prostate cancer has been described as more limited. A 2022 study noted that it can be a valid surgical option, but evidence in the high-risk setting was still sparse.
So, higher-risk cancer does not always mean Retzius-sparing surgery is impossible. It does mean the decision needs extra care and detailed discussion. Cancer control must remain the main priority when choosing the safest surgical approach.
Positive Surgical Margin Risk Must Be Discussed
A positive surgical margin means cancer cells are found at the edge of the removed prostate tissue. This can happen after any prostate cancer surgery. However, it is an important point to discuss with Retzius-sparing surgery because some studies have raised concerns in certain cases.
A 2025 meta-analysis reported faster continence recovery with Retzius-sparing surgery. However, it also noted a tendency towards higher positive surgical margin rates. This is why suitability should not be judged only by the possibility of earlier urinary control.
Your surgeon should explain whether your tumour location, MRI findings, and biopsy results make margin risk a concern. If a conventional approach gives safer cancer clearance, that may be the better choice. The safest operation is the one that balances recovery benefits with proper cancer removal.
Men Who Prioritise Early Continence Recovery May Be Interested
One of the main reasons patients ask about Retzius-sparing surgery is urinary continence. After your prostate is removed, many men worry about leakage, pads, work, travel, and confidence. These concerns are completely understandable.
Retzius-sparing surgery may be especially attractive if early urinary control after catheter removal is one of your biggest concerns. A 2025 review supports growing evidence that this approach may improve immediate and early return of continence. However, it also notes issues such as selection bias and the need for careful interpretation.
For a suitable patient, earlier continence can make the first weeks and months after surgery feel more manageable. It may help you feel more confident returning to your daily routines. However, early continence benefits should never override cancer safety when choosing the most appropriate surgical approach for you.
Existing Urinary Function May Influence the Decision
Your urinary function before surgery may also influence treatment planning. If you already have weak flow, urgency, leakage, or bladder emptying problems, your surgeon will want to understand these clearly. These symptoms can affect what recovery may look like after surgery.
Some urinary symptoms may be caused by an enlarged prostate. Others may be linked to how well the bladder itself is working. Retzius-sparing surgery may help preserve continence structures, but it does not automatically fix every urinary problem.
If your bladder is already overactive, weak, or not emptying properly, your recovery may be different from someone with excellent bladder control before surgery. This is why you should be honest about urinary symptoms before treatment. Clear information helps your surgeon give safer and more realistic advice.
Prostate Size Can Affect Suitability
Prostate size can also matter when deciding whether Retzius-sparing surgery is suitable. A very large prostate may make surgery more technically challenging, especially through a posterior route. This can affect access, difficulty, operating time, and surgeon preference.
This does not always rule out Retzius-sparing surgery. A 2025 article noted that only a small proportion of a large Retzius-sparing robotic prostatectomy series had prostate volumes greater than 100 cc. In that report, early continence and margin outcomes appeared similar to smaller glands.
This shows that prostate size is not an automatic yes or no factor. It is one important detail your surgeon must consider as part of the full picture. The final decision should be based on your prostate size, cancer location, anatomy, and surgical safety.
Previous Pelvic Surgery May Matter
Previous pelvic surgery can affect whether Retzius-sparing surgery is suitable. Operations in the pelvis may create scar tissue, change the anatomy, or make surgical access more difficult. This can influence which approach is safer.
This may include previous prostate surgery, bladder surgery, bowel surgery, hernia repairs, or other procedures depending on your case. Your surgeon will review what was done before and whether it affects the robotic approach. These details help with safer planning.
Sometimes Retzius-sparing surgery may still be possible after previous surgery. In other cases, conventional robotic surgery may be safer or more practical. You should tell your surgeon about all previous abdominal, pelvic, urinary, or bowel operations.
Previous TURP or Prostate Procedures May Be Relevant
Some men have had previous procedures for urinary symptoms, such as TURP or other prostate treatments. These procedures may change the shape of the prostate, bladder neck, or urethra. This can affect how radical prostatectomy is planned.
A 2025 article discussing Retzius-sparing robotic prostatectomy noted that selection bias can happen when prior TURP patients are excluded from studies. This is important because it may affect how reported outcomes are understood. It also shows why your own surgical history matters.
This does not mean previous TURP always rules out Retzius-sparing surgery. It means your surgeon needs to know about it and assess whether it changes the safest surgical route. The final decision should be based on your anatomy, cancer details, and previous treatment history.
Body Shape and Anatomy Can Influence Planning
Every patient’s anatomy is different. Pelvic shape, body habitus, prostate position, abdominal fat, previous surgery, and internal tissue planes can all affect how difficult surgery may be. These details can influence which approach is safest.
Robotic surgery gives excellent vision and precision, but it does not make anatomy irrelevant. If access is difficult, your surgeon may choose the approach that gives the safest view. Cancer control must always remain the main priority.
This may mean Retzius-sparing surgery is suitable for some patients and conventional robotic surgery is better for others. The right choice should be practical and safe. It should not be based only on what sounds more advanced.
Surgeon Experience Is Essential
Retzius-sparing robotic prostate surgery is technically demanding. The surgeon works from a different direction, and the anatomy can appear different compared with conventional robotic prostatectomy. This makes surgeon experience one of the most important suitability factors.
A patient may be suitable for Retzius-sparing surgery in theory. However, the result also depends on whether the surgeon is experienced with this specific approach. Good outcomes need both the right patient and the right surgical expertise.
A 2023 review describes Retzius-sparing robotic-assisted prostatectomy as a technically challenging procedure requiring careful patient selection and surgical expertise. This reinforces the need for careful technique, experience, and patient selection. It is reasonable to ask how often your surgeon performs Retzius-sparing prostatectomy and how they decide who is suitable.
Hospital Experience and Available Support Matter
Suitability is not only about the surgeon. The wider hospital team also matters, including anaesthetists, specialist nurses, pelvic floor support, catheter care, imaging quality, pathology review, and follow-up systems. These services can affect how safely and smoothly your treatment is managed.
A good prostate cancer pathway does not end when the operation finishes. You may need support with catheter removal, continence recovery, erectile function, PSA monitoring, wound care, and emotional adjustment. This support can make recovery feel clearer and less overwhelming.
If Retzius-sparing surgery is being offered, it should be part of a well-organised prostate cancer service. The right support system helps you recover with better guidance and confidence. It also ensures that any concerns after surgery are reviewed and managed properly.
Men Wanting Nerve-Sparing Need Individual Assessment
Many men ask whether Retzius-sparing surgery is suitable if they want nerve-sparing surgery. Nerve-sparing may be possible with either Retzius-sparing or conventional robotic surgery. However, it depends mainly on cancer safety.
The nerves involved in erections run close to the prostate. If the cancer is close to these nerves, your surgeon may need to remove tissue more widely. This helps reduce the risk of leaving cancer behind.
Retzius-sparing surgery does not automatically mean better erectile recovery. A 2025 meta-analysis found faster continence recovery with Retzius-sparing surgery, but it did not show a clear erectile-function advantage over conventional surgery.
If sexual function is important to you, ask specifically about nerve-sparing, erectile rehabilitation, and realistic recovery expectations. Your surgeon should explain what may be possible in your individual case.
Fertility Considerations Are the Same
Retzius-sparing surgery is still radical prostatectomy. This means the prostate and seminal vesicles are removed. After surgery, you will no longer ejaculate semen. You may still be able to have an orgasm, but it will be a dry orgasm.
Natural fertility is affected after prostate removal, regardless of whether the operation is Retzius-sparing or conventional. If future fertility matters to you, sperm storage should be discussed before surgery. This is not a suitability factor for Retzius-sparing specifically, but it is a major treatment-planning point before any prostate removal operation.
General Health and Fitness Matter
Your general health affects whether surgery is suitable at all. Your surgeon and anaesthetist may consider your heart health, lung health, diabetes, weight, blood pressure, previous clots, medicines, frailty, and ability to recover from anaesthetic.
Some men may be better suited to surgery. Others may be advised to consider radiotherapy or another treatment approach. If you are suitable for surgery generally, the next question is whether Retzius-sparing surgery is the right surgical route. Fitness for surgery and suitability for Retzius-sparing surgery are related but not the same. Both need to be assessed.
Age Alone Does Not Decide Suitability
Age matters, but it does not decide everything. A fit man in his 70s may be a better surgical candidate than a younger man with several serious medical conditions. Your surgeon will look at your biological fitness, cancer risk, expected benefit, recovery ability, and personal goals.
Retzius-sparing surgery may be discussed if surgery itself is appropriate and the cancer features fit the technique. However, if surgery is not the best treatment overall, the Retzius-sparing approach becomes less relevant. The first decision is whether prostate cancer surgery is right for you.
Patients With Strong Continence Concerns May Ask About It
If early urinary control is one of your biggest concerns, it is reasonable to ask about Retzius-sparing surgery. Many men worry about needing pads, leaking at work, or losing confidence after catheter removal. Retzius-sparing surgery was developed partly to address this concern.
However, your surgeon may still recommend conventional robotic surgery if cancer location or anatomy makes that safer. This can feel disappointing, but it does not mean your continence concerns are being ignored. A good surgeon should explain the balance between early continence recovery and safe cancer removal.
Patients With Anterior Tumours Need Extra Careful Counselling
Anterior tumours deserve special discussion. Because Retzius-sparing surgery preserves the front space and approaches the prostate from behind, cancers located at the front may create additional margin concerns.
Evidence has shown higher positive surgical margin rates for anterior tumours in Retzius-sparing surgery compared with conventional anterior robotic prostatectomy, while the same pattern was not seen for posterior tumours.
This does not mean all anterior tumours must have conventional surgery. But it does mean you should ask your surgeon directly about tumour location and margin risk.
Patients With Posterior Tumours May Be More Straightforward
Posterior tumours may be more compatible with the Retzius-sparing route in some patients, because the surgeon is approaching from behind. However, this still depends on tumour grade, stage, size, capsule involvement, prostate anatomy, and surgeon judgement.
No single feature automatically makes someone suitable. A posterior tumour may make the discussion more favourable, but the whole cancer picture still matters. Your surgeon should explain how your MRI and biopsy findings affect the decision. This is why personalised surgical planning is essential.
Men Needing Wider Cancer Removal May Not Be Ideal Candidates
Sometimes prostate cancer surgery requires a wider dissection to improve cancer clearance. If the cancer appears close to the edge of the prostate, near important structures, or has higher-risk features, the surgeon may choose the approach that gives the best exposure and control.
In some cases, that may be conventional robotic surgery. Retzius-sparing surgery aims to preserve structures, but preservation must not compromise cancer removal. If your surgeon recommends against Retzius-sparing surgery, ask whether it is because wider clearance is needed. This can help you understand the decision rather than feeling you are missing out.
Lymph Node Removal May Influence the Plan
Some patients need pelvic lymph node removal during prostate cancer surgery. This may be recommended if the cancer has features that increase the risk of spread to lymph nodes. Lymph node removal can often be performed with robotic surgery, but the need for it may influence surgical planning and access.
Your surgeon will decide whether lymph node removal is needed based on your PSA, biopsy grade, MRI findings, staging, and risk calculations. If you need lymph node removal, ask whether Retzius-sparing surgery is still suitable. The answer may depend on your surgeon’s experience and your individual anatomy.
Retzius-Sparing Surgery Is Not a Marketing Choice
It is easy to be drawn to surgical terms that sound advanced. However, Retzius-sparing surgery should not be chosen because it sounds newer, more technical, or more impressive. It should be chosen because it is appropriate for your cancer and offers a meaningful benefit in your situation.
A conventional robotic prostatectomy may be the better operation for some men. A well-performed conventional operation that prioritises cancer control may be safer than forcing a Retzius-sparing approach in a difficult case. The best decision is not about choosing the most advanced-sounding technique. It is about choosing the most appropriate treatment.
When Conventional Robotic Surgery May Be Better
Conventional robotic surgery may be better if the tumour location makes Retzius-sparing surgery less suitable. It may also be preferred if your surgeon needs better anterior access, wider margins, or a different angle for safe dissection.
It may be recommended if you have a very large prostate, previous surgery, complex anatomy, or if your surgeon feels the conventional route is safer. Conventional robotic surgery remains a standard and widely used approach.
It can offer strong cancer control and good functional outcomes when performed by an experienced surgeon. Choosing conventional surgery does not mean choosing an inferior treatment.
Factors That Determine Suitability for Retzius-Sparing Robotic Prostate Surgery
| Factor | More Suitable for Retzius-Sparing Surgery | Less Suitable / Caution |
|---|---|---|
| Cancer stage | Localised prostate cancer | Locally advanced or complex cases |
| Tumour location | Posterior / favourable location | Anterior tumours (higher margin risk reported) |
| MRI findings | Clear margins, low extracapsular risk | Suspicion of capsule involvement or difficult location |
| Cancer grade | Low to intermediate risk (selected cases) | High-risk disease needing wider excision |
| Prostate size | Normal to moderately enlarged | Very large prostate (technical difficulty) |
| Previous pelvic surgery | No significant prior surgery | Previous TURP or complex pelvic surgery |
| Lymph node removal need | Not required | Likely required (may affect approach) |
| Anatomy | Standard pelvic anatomy | Complex anatomy / difficult access |
| Surgeon experience | High-volume RS-RARP surgeon | Limited experience with technique |
| Patient priority | Early continence recovery important | Cancer control priority above all |
When Retzius-Sparing Surgery May Be a Good Option
Retzius-sparing surgery may be a good option if your prostate cancer is suitable for surgery, your tumour location is favourable, your anatomy allows safe access, and your surgeon has experience with the technique.
It may be especially appealing if early urinary continence recovery is a major priority for you. It may also be considered when the surgeon believes the cancer can be removed safely without increasing margin risk. In the right patient, the approach may offer meaningful early recovery benefits. But it should always be recommended after reviewing your full clinical picture.
What Your Surgeon Will Usually Review
Your surgeon will usually review several details before deciding suitability. These include PSA level, MRI findings, biopsy grade, cancer location, tumour volume, clinical stage, prostate size, urinary symptoms, erectile function, previous surgery, general health, and patient preferences.
They may also consider whether nerve-sparing is possible and whether lymph node removal is needed. This is why a detailed consultation is important. A quick yes or no answer is rarely enough. You should leave the consultation understanding why the technique is or is not recommended for you.
What If You Are Not Suitable?
If you are not suitable for Retzius-sparing surgery, it does not mean your treatment options are poor. Conventional robotic prostate surgery may still be very appropriate. Radiotherapy, active surveillance, or other treatment options may also be discussed depending on your cancer.
The goal is not to force one technique. The goal is to choose the treatment that gives you the best balance of cancer control, urinary recovery, sexual function, safety, and long-term follow-up. If your surgeon advises against Retzius-sparing surgery, ask for the reason. Understanding the reason can make the recommendation easier to accept.
Speak to Our Specialist
If you are wondering whether Retzius-sparing robotic prostate surgery is suitable for you, a specialist consultation can help. You may need advice based on your PSA, MRI scan, biopsy results, tumour location, prostate size, urinary symptoms, erectile function, previous surgery, general health, and personal priorities.
A specialist can explain whether this approach offers a real benefit in your case or whether conventional robotic surgery may be safer. They can also discuss continence recovery, cancer control, nerve-sparing, catheter time, return to work, and long-term follow-up. This can help you make a decision based on your own cancer, not general claims.
Frequently Asked Questions (FAQs)
1. Who is generally suitable for Retzius-sparing robotic prostate surgery?
Men with localised prostate cancer, favourable tumour location, and anatomy that allows safe posterior access may be suitable. Suitability depends on detailed assessment of MRI, biopsy results, PSA level, and overall health.
2. Is Retzius-sparing surgery suitable for all prostate cancer patients?
No. It is not suitable for everyone. Tumour position, cancer aggressiveness, prostate size, and the need for wider cancer removal can all make conventional robotic surgery a safer option in some cases.
3. Why does tumour location matter for suitability?
Tumour location influences how safely the cancer can be removed. Anterior tumours (towards the front of the prostate) may carry a higher risk of positive surgical margins with Retzius-sparing surgery, so careful selection is required.
4. Can patients with higher-risk prostate cancer have Retzius-sparing surgery?
Sometimes, but only in carefully selected cases. Evidence is more limited in high-risk disease, and surgeons may prefer conventional robotic surgery if wider cancer clearance is needed for safety.
5. Does having a large prostate make Retzius-sparing surgery unsuitable?
Not always. A larger prostate can make surgery more technically challenging, but it does not automatically rule it out. Suitability depends on anatomy, surgeon experience, and cancer characteristics.
6. Does previous pelvic or prostate surgery affect eligibility?
Yes, it can. Previous procedures such as TURP or pelvic surgery may alter anatomy or create scar tissue, which can influence whether the Retzius-sparing approach is safe or practical.
7. Can I choose Retzius-sparing surgery because I want faster continence recovery?
You can discuss it, but continence benefit alone is not enough. Cancer safety always comes first, and your surgeon will only recommend it if it is appropriate for your specific tumour and anatomy.
8. Is Retzius-sparing surgery better for preserving erectile function?
Not necessarily. Current research does not show a clear advantage in erectile function compared with conventional robotic surgery. Nerve-sparing ability and cancer location are more important factors.
9. What tests are used to decide suitability for Retzius-sparing surgery?
Doctors typically review PSA levels, MRI scans, biopsy results, tumour location, cancer grade, prostate size, urinary symptoms, and overall health to determine whether the approach is appropriate.
10. What happens if I am not suitable for Retzius-sparing surgery?
If you are not suitable, it does not mean you have limited options. Conventional robotic prostate surgery, radiotherapy, or active surveillance may still be appropriate depending on your cancer profile and overall health.
Final Thoughts: Suitability for Retzius-Sparing Robotic Prostate Surgery
Deciding whether Retzius-sparing robotic prostate surgery is suitable is not about choosing the most advanced technique. It is about matching the right surgical approach to your cancer characteristics, anatomy, and overall treatment goals.
For some patients, this approach may offer the benefit of earlier urinary continence recovery. For others, conventional robotic prostate surgery may provide a safer or more appropriate route for complete cancer removal. The key is careful assessment, not preference for a particular surgical style. If you are considering retzius-sparing robotic prostate surgery in London, you can get in touch with us for a consultation.
References:
- Ferretti, S. et al. (2023) Retzius-sparing robotic-assisted prostatectomy: technical challenges for surgeons Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10725648/
- Shimura, S., Koguchi, D., Tabata, K.-I., Shiba, I., Shiono, Y., Mori, K., Hirano, S., Ikeda, M., Tsumura, H., Ishii, D. and Matsumoto, K. (2025) A comparative analysis of the functional outcomes between Retzius-sparing and conventional robot-assisted radical prostatectomy using the Expanded Prostate Cancer Index Composite. Cancers, 17(24), 3913. Available at: https://www.mdpi.com/2072-6694/17/24/3913
- Chen, J.-K., Chang, Y.-J., Lin, C.-B., Pan, Y. and Wang, P.-F. (2025) Occurrence and impact of intraoperative anastomotic leakage in Retzius-sparing robot-assisted radical prostatectomy, Medicina, 61(5), 886. Available at: https://www.mdpi.com/1648-9144/61/5/886
- Lee, J., Kim, H.Y., Goh, H.J. et al. (2020) Retzius sparing robot-assisted radical prostatectomy conveys early regain of continence over conventional robot-assisted radical prostatectomy: a propensity score matched analysis of 1,863 patients The Journal of Urology. Available at: https://pubmed.ncbi.nlm.nih.gov/31347951/
- Phukan, C., McLean, A., Nambiar, A. et al. (2020) Retzius-sparing robotic assisted radical prostatectomy vs conventional robotic assisted radical prostatectomy: a systematic review and meta-analysis. World Journal of Urology. Available at: https://pubmed.ncbi.nlm.nih.gov/31089802/