Highlights from

EAU 2020

European Association of Urology annual congress

Virtual 17-19 July 2020

Prostatectomy: R-LRPE better than LRPE for continence

New findings from the first prospective, multicentre, randomised trial demonstrated improved continence for patients undergoing robotic-assisted radical prostatectomy as compared with conventional laparoscopic radical prostatectomy.

Prof. Jens-Uwe Stolzenburg (University of Leipzig, Germany) presented the results of the LAP-01 study, which aimed to generate conclusive data supporting improved continence after robotic-assisted radical prostatectomy (R-LRPE) in a prospective setting in 4 German centres [1].

Patients (at data cut-off, n=713) were randomised 3:1 to either robotic-assisted (n=527) or conventional laparoscopic radical prostatectomy (LRPE; n=186); patients were blinded to their arm allocation until month 3. The primary endpoint of the study was continence restoration at month 3, as defined by not requiring a pad for 3 or more consecutive days. Post-operative follow-up will be continued for 3 years, with assessments planned for 1, 3, 6, 12, 24, and 36 months. Prof. Stolzenburg presented the data up to 12 months.

Overall, complication rates were lower in patients who received robotic surgery. Perioperative outcomes were comparable between both arms, including nerve-sparing rates, prostate size/weight, margin status, pathological tumour stage, duration of surgery, and duration of catheterisation. However, the primary endpoint was met; continence rates among the patients treated robotically were significantly higher at 3 months (P=0.00064), 6 months (P=0.004), and 12 months (P=0.044). Continued follow-up will determine the longer-term effects.

  1. Stolzenburg J-U, et al. Continence Following Robot-Assisted (R-LRPE) and Conventional Laparoscopic Radical Prostatectomy (LRPE) – Results of a Prospective, Randomized, Multicenter, Patient Blinded Study. EAU20 Virtual Congress, 17-26 July 2020, Game-Changing Session 1.

Top image: © Mohammed Haneefa Nizamudeen

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