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Olivero et al. Mini-invasive Surg 2022;6:6 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.117

Original Article Open Access

Trifecta results in Retzius-sparing robotic radical

prostatectomy: results of a high-volume center

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Alberto Olivero , Paolo Dell’Oglio 1,2,3 , Francesca Ambrosini , Silvia Secco , Michele Barbieri , Erika
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Palagonia , Giancarlo Napoli , Elena Strada , Giovanni Petralia , Dario Di Trapani , Carlo Buratto , Marco
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Martiriggiano , Antonio Galfano , Aldo Massimo Bocciardi 1
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Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan 20121, Italy.
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Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam 1066, The Netherlands.
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Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden 2333, The
Netherlands.
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Department of Urology, Policlinico San Martino Hospital, University of Genova, Genova 16131, Italy.
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Division of Urology, University Hospital “Ospedali Riuniti”, Marche Polytechnic University, Ancona 60126, Italy.
Correspondence to: Dr. Alberto Olivero, Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, piazza
Ospedale Maggiore 3, Milan 20121, Italy. E-mail: oliveroalby@gmail.com
How to cite this article: Olivero A, Dell’Oglio P, Ambrosini F, Secco S, Barbieri M, Palagonia E, Napoli G, Strada E, Petralia G, Di
Trapani D, Buratto C, Martiriggiano M, Galfano A, Bocciardi AM. Trifecta results in Retzius-sparing robotic radical
prostatectomy: results of a high-volume center. Mini-invasive Surg 2022;6:6. https://dx.doi.org/10.20517/2574-1225.2021.117
Received: 18 Oct 2021 First Decision: 25 Nov 2021 Revised: 23 Dec 2021 Accepted: 29 Dec 2021 Published: 17 Jan 2022
Academic Editors: Giulio Belli, Riccardo Autorino, Enrico Checcucci Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen
Abstract
Aim: We aimed to evaluate trifecta outcomes after Retzius-sparing robot-assisted radical prostatectomy (rs-
RARP).
Methods: We evaluated 1488 patients who had undergone rs-RARP at our institution from 2011 to 2019. All
patients filled out questionaries for functional outcomes before surgery, and only patients with baseline continence
and IIEF-5 scores of > 16 were included. Biochemical recurrence (BCR) was defined as two consecutive prostatic
specific antigen levels of > 0.2 ng/mL after rs-RARP. Postoperative continence was defined as the use of no pads.
Potency was defined as the ability to achieve erections for sexual intercourse, with or without phosphodiesterase-5
(PDE-5) inhibitors. A multivariable logistic regression model was performed to identify predictors of trifecta
outcome.

Results: In total, 1240 patients were included in the analysis. During the 24-month follow-up time, 149 patients
(11.9%) harbored BCR. Urinary continence was observed in 981 patients (79.5%), while 171 (13.8%) still used a
safety pad daily after 24 months. Sexual potency was reported in 643 patients (51.9%), of whom 379 (30.6%) had

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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