Total en Bloc Urethra Preservation at Robot-Assisted Prostatectomy (ToP-RAP): A Prospective IDEAL Stage 1–2a Study

Abstract

Simple Summary After prostate cancer surgery, some men may have urinary leakage that can strongly affect daily life, even when modern robotic techniques are used. This study introduces a new robotic surgical approach, Total en bloc Urethra Preservation at Robot-assisted Prostatectomy, designed to keep the entire urine channel inside the prostate intact and avoid cutting and reconnecting it. The authors aimed to test whether this technique can be performed safely in carefully selected men with localized prostate cancer and whether it may allow faster recovery of urinary control without early signs of reduced cancer control. In the first 16 patients, 15 regained urinary control, most within a few days, and no early cancer recurrence or additional treatment was observed during short follow-up. These early results may guide further research into function-preserving prostate cancer surgery, but larger studies with longer follow-up are needed.