Background: Radical retropubic prostatectomy is associated with potential incontinence and urinary complications. We evaluated the urinary complications and recovery of continence in men undergoing robot-assisted extraperitoneal radical prostatectomy using the daVinci Surgical system.
Methods: A total of 150 consecutive men underwent daVinci robot-assisted extraperitoneal radical prostatectomy over a fifteen month period. Immediate and delayed urinary complications were compiled and recovery of continence was determined at one month and then three month intervals post-operatively.
Results: Preoperative demographics included mean age of 60 (46-76); mean preoperative PSA of 6.6 (0.6-26); and a mean Gleason grade of 6 (4-7). The mean prostate weight was 53g (23-200). There were 5 (3.3%) immediate urinary complications including urinary leak (3) and clot retention (2). There were 19 (12.7%) delayed urinary complications including bladder neck contracture (6), urinary retention (5), UTI (6), epididymitis (1) and urinoma (1). Continence data was available for 110 patients who were at least 6 months post-prostatectomy. Overall continence rate (no pads/one safety liner) was 92% within 3 months with 28% of the patients having immediate (upon catheter removal at one week post-op) control of continence.
Conclusion: Robot-assisted extraperitoneal radical prostatectomy provides excellent immediate and long-term continence. Complete recovery of continence can be expected in 3 months for most patients. The immediate and delayed urinary complications witnessed are comparable to the open conventional technique. Overall, the robot-assisted extraperitoneal approach offers equivalent results with decreased morbidity and shorter convalescence.

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