Retzius-Sparing
Robotic Prostatectomy
A posterior surgical approach to robotic prostatectomy, designed to leave the front support structures of the bladder and urethra undisturbed — with the aim of an earlier return of urinary continence.
A variation of robotic prostatectomy, not a different operation
Retzius-sparing robotic prostatectomy is a variation of robotic-assisted radical prostatectomy for localised prostate cancer, with one main aim: earlier urinary control after surgery. Rather than approaching the prostate from the front — the more familiar route in standard robotic prostatectomy — the operation is performed from behind, through the pouch of Douglas, avoiding the space in front of the bladder known as the Retzius space.
By leaving these front-facing support structures undisturbed, the aim is to protect the anatomy that helps continence return more quickly once the catheter is removed. It remains, in every respect, a robotic radical prostatectomy — the prostate is still removed and the cancer objective is unchanged.
Retzius-sparing vs. standard robotic prostatectomy
| Feature | Standard robotic prostatectomy | Retzius-sparing |
|---|---|---|
| Surgical route | Anterior approach | Posterior approach |
| Retzius space | Opened during surgery | Largely preserved |
| Main functional rationale | Established robotic technique | Aims for earlier continence recovery |
| Early continence | Good, though slower in some series | Often better in the first weeks and months |
| Continence at 6–12 months | Generally strong | Often similar to standard by this point |
| Oncological safety | Assessed via margin and recurrence data | Comparable in published comparative studies |
Suitability depends on the individual, not the label
Who may be suitable
Suitability depends on anatomy, prior abdominal or pelvic surgery, tumour features, and Mr Sri's assessment of what offers the safest cancer clearance — not on having localised disease alone. Retzius-sparing surgery is technically demanding, and outcomes are shaped by case selection and operative judgement as much as by the technique's name.
At consultation, Mr Sri reviews your MRI and biopsy findings, discusses your priorities, and recommends whichever technique — Retzius-sparing or standard nerve-sparing — best fits your anatomy and cancer characteristics.
Worth asking at consultation
- Am I a good candidate for the Retzius-sparing approach?
- Does my tumour position make this technique more or less appropriate?
- What continence results are typical in the early weeks?
- Is nerve-sparing likely to be possible in my case?
- How long will I have a catheter, and when can I return to work?
- What pelvic floor or rehabilitation support is offered afterwards?
Discuss your options with Mr Sri
Same-week appointments across four London locations. No GP referral required.