Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes
Purpose To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence. Methods An independent systematic review of the lite...
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| Veröffentlicht in: | World journal of urology 2021-10, Vol.39 (10), p.3721-3732 |
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| creator | Carbonara, Umberto Srinath, Maya Crocerossa, Fabio Ferro, Matteo Cantiello, Francesco Lucarelli, Giuseppe Porpiglia, Francesco Battaglia, Michele Ditonno, Pasquale Autorino, Riccardo |
| description | Purpose
To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence.
Methods
An independent systematic review of the literature was performed up to February 2021, using MEDLINE
®
, EMBASE
®
, and Web of Science
®
databases. Preferred reporting items for systematic review and meta-analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle–Ottawa scale for non-randomized controlled trials. Demographics and clinical characteristics, surgical, pathological, and functional outcomes were collected.
Results
Twenty-six studies were identified. Only 16 “high-quality” (RCTs and Newcastle–Ottawa scale 8–9) studies were included in the meta-analysis. Among the 13,752 patients included, 6135 (44.6%) and 7617 (55.4%) were RARP and LRP, respectively. There was no difference between groups in terms of demographics and clinical characteristics. Overall and major complication (Clavien–Dindo ≥ III) rates were similar in LRP than RARP group. The biochemical recurrence (BCR) rate at 12months was significantly lower for RARP (OR: 0.52; 95% CI 0.43–0.63;
p
|
| doi_str_mv | 10.1007/s00345-021-03687-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2511898701</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2511898701</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-3563de16194aaa50e12219b632a4fe20f101a198d1fce177c0093e09ae101aca3</originalsourceid><addsrcrecordid>eNp9kc-KFDEQxoO4uOPqC3iQgBcv0aok3en2Jov_YEFYds-hJl0tvXR3xk56YJ5hX9qMsyqIeApJ_b6vqvIJ8QLhDQK4twnA2EqBRgWmbpyqHokNWmNU43T9WGzAaats25hz8TSlOwB0NVRPxLkxjTWA9UbcX8dtzIpSGlLmTi7UDYFGuVtiypQ55Dgd5J6XtCZZXuaOlk6OtKMChLgbwr8l7yTNkvdDx3NgtaVUvGmm8VD6yNjLEKdiQXnYs4xrLldOz8RZT2Pi5w_nhbj9-OHm8rO6-vrpy-X7KxWsxaxMVZuOscbWElEFjFpju62NJtuzhh4BCdumwz4wOhcAWsPQEh8LgcyFeH3yLRN_XzllPw0p8DjSzHFNXleITds4wIK--gu9i-tS9jhSjdbOVlAVSp-oUL4gLdz73TJMtBw8gj9G5U9R-RKV_xmVP4pePliv24m735Jf2RTAnIBUSvM3Xv70_o_tD18job0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2582274505</pqid></control><display><type>article</type><title>Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Carbonara, Umberto ; Srinath, Maya ; Crocerossa, Fabio ; Ferro, Matteo ; Cantiello, Francesco ; Lucarelli, Giuseppe ; Porpiglia, Francesco ; Battaglia, Michele ; Ditonno, Pasquale ; Autorino, Riccardo</creator><creatorcontrib>Carbonara, Umberto ; Srinath, Maya ; Crocerossa, Fabio ; Ferro, Matteo ; Cantiello, Francesco ; Lucarelli, Giuseppe ; Porpiglia, Francesco ; Battaglia, Michele ; Ditonno, Pasquale ; Autorino, Riccardo</creatorcontrib><description>Purpose
To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence.
Methods
An independent systematic review of the literature was performed up to February 2021, using MEDLINE
®
, EMBASE
®
, and Web of Science
®
databases. Preferred reporting items for systematic review and meta-analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle–Ottawa scale for non-randomized controlled trials. Demographics and clinical characteristics, surgical, pathological, and functional outcomes were collected.
Results
Twenty-six studies were identified. Only 16 “high-quality” (RCTs and Newcastle–Ottawa scale 8–9) studies were included in the meta-analysis. Among the 13,752 patients included, 6135 (44.6%) and 7617 (55.4%) were RARP and LRP, respectively. There was no difference between groups in terms of demographics and clinical characteristics. Overall and major complication (Clavien–Dindo ≥ III) rates were similar in LRP than RARP group. The biochemical recurrence (BCR) rate at 12months was significantly lower for RARP (OR: 0.52; 95% CI 0.43–0.63;
p
< 0.00001). RARP reported lower urinary incontinence rate at 12months (OR: 0.38; 95% CI 0.18–0.8;
p
= 0.01). The erectile function recovery rate at 12months was higher for RARP (OR: 2.16; 95% CI 1.23–3.78;
p
= 0.007).
Conclusion
Current evidence shows that RARP offers favorable outcomes compared with LRP, including higher potency and continence rates, and less likelihood of BCR. An assessment of longer-term outcomes is lacking, and higher cost remains a concern of robotic versus laparoscopic prostate cancer surgery.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-021-03687-5</identifier><identifier>PMID: 33843016</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cancer surgery ; Clinical trials ; Demography ; Erectile Dysfunction - epidemiology ; Evidence-Based Practice ; Humans ; Invited Review ; Laparoscopy ; Laparoscopy - methods ; Literature reviews ; Male ; Medicine ; Medicine & Public Health ; Meta-analysis ; Neoplasm Recurrence, Local - blood ; Neoplasm Recurrence, Local - epidemiology ; Nephrology ; Oncology ; Postoperative Complications - epidemiology ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatectomy ; Prostatectomy - methods ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Recovery of Function ; Robotic surgery ; Robotic Surgical Procedures - methods ; Systematic review ; Urinary incontinence ; Urinary Incontinence - epidemiology ; Urological surgery ; Urology</subject><ispartof>World journal of urology, 2021-10, Vol.39 (10), p.3721-3732</ispartof><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021</rights><rights>2021. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.</rights><rights>This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-3563de16194aaa50e12219b632a4fe20f101a198d1fce177c0093e09ae101aca3</citedby><cites>FETCH-LOGICAL-c441t-3563de16194aaa50e12219b632a4fe20f101a198d1fce177c0093e09ae101aca3</cites><orcidid>0000-0001-7045-7725</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-021-03687-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-021-03687-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33843016$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Carbonara, Umberto</creatorcontrib><creatorcontrib>Srinath, Maya</creatorcontrib><creatorcontrib>Crocerossa, Fabio</creatorcontrib><creatorcontrib>Ferro, Matteo</creatorcontrib><creatorcontrib>Cantiello, Francesco</creatorcontrib><creatorcontrib>Lucarelli, Giuseppe</creatorcontrib><creatorcontrib>Porpiglia, Francesco</creatorcontrib><creatorcontrib>Battaglia, Michele</creatorcontrib><creatorcontrib>Ditonno, Pasquale</creatorcontrib><creatorcontrib>Autorino, Riccardo</creatorcontrib><title>Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence.
Methods
An independent systematic review of the literature was performed up to February 2021, using MEDLINE
®
, EMBASE
®
, and Web of Science
®
databases. Preferred reporting items for systematic review and meta-analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle–Ottawa scale for non-randomized controlled trials. Demographics and clinical characteristics, surgical, pathological, and functional outcomes were collected.
Results
Twenty-six studies were identified. Only 16 “high-quality” (RCTs and Newcastle–Ottawa scale 8–9) studies were included in the meta-analysis. Among the 13,752 patients included, 6135 (44.6%) and 7617 (55.4%) were RARP and LRP, respectively. There was no difference between groups in terms of demographics and clinical characteristics. Overall and major complication (Clavien–Dindo ≥ III) rates were similar in LRP than RARP group. The biochemical recurrence (BCR) rate at 12months was significantly lower for RARP (OR: 0.52; 95% CI 0.43–0.63;
p
< 0.00001). RARP reported lower urinary incontinence rate at 12months (OR: 0.38; 95% CI 0.18–0.8;
p
= 0.01). The erectile function recovery rate at 12months was higher for RARP (OR: 2.16; 95% CI 1.23–3.78;
p
= 0.007).
Conclusion
Current evidence shows that RARP offers favorable outcomes compared with LRP, including higher potency and continence rates, and less likelihood of BCR. An assessment of longer-term outcomes is lacking, and higher cost remains a concern of robotic versus laparoscopic prostate cancer surgery.</description><subject>Cancer surgery</subject><subject>Clinical trials</subject><subject>Demography</subject><subject>Erectile Dysfunction - epidemiology</subject><subject>Evidence-Based Practice</subject><subject>Humans</subject><subject>Invited Review</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Literature reviews</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Neoplasm Recurrence, Local - blood</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatectomy</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Recovery of Function</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Systematic review</subject><subject>Urinary incontinence</subject><subject>Urinary Incontinence - epidemiology</subject><subject>Urological surgery</subject><subject>Urology</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kc-KFDEQxoO4uOPqC3iQgBcv0aok3en2Jov_YEFYds-hJl0tvXR3xk56YJ5hX9qMsyqIeApJ_b6vqvIJ8QLhDQK4twnA2EqBRgWmbpyqHokNWmNU43T9WGzAaats25hz8TSlOwB0NVRPxLkxjTWA9UbcX8dtzIpSGlLmTi7UDYFGuVtiypQ55Dgd5J6XtCZZXuaOlk6OtKMChLgbwr8l7yTNkvdDx3NgtaVUvGmm8VD6yNjLEKdiQXnYs4xrLldOz8RZT2Pi5w_nhbj9-OHm8rO6-vrpy-X7KxWsxaxMVZuOscbWElEFjFpju62NJtuzhh4BCdumwz4wOhcAWsPQEh8LgcyFeH3yLRN_XzllPw0p8DjSzHFNXleITds4wIK--gu9i-tS9jhSjdbOVlAVSp-oUL4gLdz73TJMtBw8gj9G5U9R-RKV_xmVP4pePliv24m735Jf2RTAnIBUSvM3Xv70_o_tD18job0</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Carbonara, Umberto</creator><creator>Srinath, Maya</creator><creator>Crocerossa, Fabio</creator><creator>Ferro, Matteo</creator><creator>Cantiello, Francesco</creator><creator>Lucarelli, Giuseppe</creator><creator>Porpiglia, Francesco</creator><creator>Battaglia, Michele</creator><creator>Ditonno, Pasquale</creator><creator>Autorino, Riccardo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7045-7725</orcidid></search><sort><creationdate>20211001</creationdate><title>Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes</title><author>Carbonara, Umberto ; Srinath, Maya ; Crocerossa, Fabio ; Ferro, Matteo ; Cantiello, Francesco ; Lucarelli, Giuseppe ; Porpiglia, Francesco ; Battaglia, Michele ; Ditonno, Pasquale ; Autorino, Riccardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-3563de16194aaa50e12219b632a4fe20f101a198d1fce177c0093e09ae101aca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cancer surgery</topic><topic>Clinical trials</topic><topic>Demography</topic><topic>Erectile Dysfunction - epidemiology</topic><topic>Evidence-Based Practice</topic><topic>Humans</topic><topic>Invited Review</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Literature reviews</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Neoplasm Recurrence, Local - blood</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatectomy</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Recovery of Function</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Systematic review</topic><topic>Urinary incontinence</topic><topic>Urinary Incontinence - epidemiology</topic><topic>Urological surgery</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carbonara, Umberto</creatorcontrib><creatorcontrib>Srinath, Maya</creatorcontrib><creatorcontrib>Crocerossa, Fabio</creatorcontrib><creatorcontrib>Ferro, Matteo</creatorcontrib><creatorcontrib>Cantiello, Francesco</creatorcontrib><creatorcontrib>Lucarelli, Giuseppe</creatorcontrib><creatorcontrib>Porpiglia, Francesco</creatorcontrib><creatorcontrib>Battaglia, Michele</creatorcontrib><creatorcontrib>Ditonno, Pasquale</creatorcontrib><creatorcontrib>Autorino, Riccardo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carbonara, Umberto</au><au>Srinath, Maya</au><au>Crocerossa, Fabio</au><au>Ferro, Matteo</au><au>Cantiello, Francesco</au><au>Lucarelli, Giuseppe</au><au>Porpiglia, Francesco</au><au>Battaglia, Michele</au><au>Ditonno, Pasquale</au><au>Autorino, Riccardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2021-10-01</date><risdate>2021</risdate><volume>39</volume><issue>10</issue><spage>3721</spage><epage>3732</epage><pages>3721-3732</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence.
Methods
An independent systematic review of the literature was performed up to February 2021, using MEDLINE
®
, EMBASE
®
, and Web of Science
®
databases. Preferred reporting items for systematic review and meta-analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle–Ottawa scale for non-randomized controlled trials. Demographics and clinical characteristics, surgical, pathological, and functional outcomes were collected.
Results
Twenty-six studies were identified. Only 16 “high-quality” (RCTs and Newcastle–Ottawa scale 8–9) studies were included in the meta-analysis. Among the 13,752 patients included, 6135 (44.6%) and 7617 (55.4%) were RARP and LRP, respectively. There was no difference between groups in terms of demographics and clinical characteristics. Overall and major complication (Clavien–Dindo ≥ III) rates were similar in LRP than RARP group. The biochemical recurrence (BCR) rate at 12months was significantly lower for RARP (OR: 0.52; 95% CI 0.43–0.63;
p
< 0.00001). RARP reported lower urinary incontinence rate at 12months (OR: 0.38; 95% CI 0.18–0.8;
p
= 0.01). The erectile function recovery rate at 12months was higher for RARP (OR: 2.16; 95% CI 1.23–3.78;
p
= 0.007).
Conclusion
Current evidence shows that RARP offers favorable outcomes compared with LRP, including higher potency and continence rates, and less likelihood of BCR. An assessment of longer-term outcomes is lacking, and higher cost remains a concern of robotic versus laparoscopic prostate cancer surgery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33843016</pmid><doi>10.1007/s00345-021-03687-5</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-7045-7725</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0724-4983 |
| ispartof | World journal of urology, 2021-10, Vol.39 (10), p.3721-3732 |
| issn | 0724-4983 1433-8726 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Cancer surgery Clinical trials Demography Erectile Dysfunction - epidemiology Evidence-Based Practice Humans Invited Review Laparoscopy Laparoscopy - methods Literature reviews Male Medicine Medicine & Public Health Meta-analysis Neoplasm Recurrence, Local - blood Neoplasm Recurrence, Local - epidemiology Nephrology Oncology Postoperative Complications - epidemiology Prostate cancer Prostate-Specific Antigen - blood Prostatectomy Prostatectomy - methods Prostatic Neoplasms - blood Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Recovery of Function Robotic surgery Robotic Surgical Procedures - methods Systematic review Urinary incontinence Urinary Incontinence - epidemiology Urological surgery Urology |
| title | Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes |
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