Retrospective cohort · Maimonides Medical Center
Urinary retention after Retzius-sparing prostatectomy
Retzius-sparing robotic prostatectomy is chosen for a reason: men regain continence sooner. The anatomy that buys that advantage — an untouched anterior compartment — is also the anatomy that could obstruct. Retention after the operation has been reported in passing, never as the outcome of interest, and nobody has said which men are at risk.
Status. Manuscript V1. An IRB protocol and a 48-reference literature review are in place for a prospective follow-on study.
This hub is still being built. The analysis is underway; the derivation, tables and figures will be posted here as they are finished, the way the completed projects on this site are. What is below is the design and the current state, written up as it stands.
The question
What is the incidence of urinary retention after Retzius-sparing RARP, and which preoperative measurements predict it?
How it is being done
- A retrospective cohort of roughly 200 consecutive patients who underwent Retzius-sparing RARP, with retention as the primary outcome rather than an incidental complication.
- Anatomic predictors: membranous urethral length, intravesical prostatic protrusion and prostate volume.
- Clinical predictors: baseline LUTS, PSA, diabetes, prior retention, prior ureteral or urethral procedures, cardiovascular and cerebrovascular disease, and a modified frailty index.
- Pharmacologic exposure before and after surgery: alpha-blockers, 5-ARIs and ADT.
What comes next
The prospective study, in which the candidate predictors are measured before surgery rather than reconstructed from charts — the design that can turn an association into a preoperative risk estimate a surgeon could act on.
This page grows as the work does.