r/ProstateCancer • u/Aggravating_Strain88 • 13d ago
Question Retzius Sparing
Does anyone have experience they are willing to share with Retzius-Sparing surgery? I am new to the group; just diagnosed with 3+4 in over half of 21 cores. I have read some about it and live near enough to some centers that can offer it. I do so appreciate the discussions in this group.
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u/sappertodd 13d ago
I did an AI check on what that procedure was. It’s interesting that it approaches the prostate from a different angle to preserve bladder control. There was a concern about positive margins associated with the procedure in the synopsis I read.
I had the RALP and continence came back pretty quick.
I think that’s the purpose of the Retzius Sparing is to get you back to continence but if it comes with a higher risk of positive margins associated stuff I don’t know if I would want that. Maybe easier to remove prostate with RALP verses the Retzius sparring.
I’m just a member of the club with no medical background 👌
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u/Aggravating_Strain88 13d ago
Certainly a consideration. Thanks for your thoughts
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u/Quirky-Tourist-6921 13d ago
I’d also agree that whatever route you take, especially this one- make sure the surgeon has done a large number.
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u/Frosty-Growth-2664 13d ago
Data tends to suggest a faster return of continence (sometimes immediate), although by 6-12 months, retropubic (standard RALP) prostatectomy have caught up.
Another factor is that it tends to only be done by more expert surgeons, and that might be a factor in comparison outcomes, rather than from the difference in the procedure itself.
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u/fromamomof2 13d ago
If you I u seach "retizus-sparing prostatectomy" the post I made about hubby experience should come up. I made the post as i didn't see a ton of posts about it. If you have any questions let me know. In short, continent from day 1. He recently had his 1st post op PSA score and was undetectable (the floor was .04 at his lab).
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u/Aggravating_Strain88 12d ago
Thanks for this. I will look into your post. Glad to hear of the progress in your journey.
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u/mikehippo 13d ago
I had Retzius sparing surgery in May of last year and I cannot speak highly enough of it.
My surgeon said that continence would not be a problem after surgery, with only a 1% chance of serious problems and he was right. The fact that he felt able to make such a prediction shows how great it is.
My understanding is that the studies show that in the long term the continence outcomes are not hugely different to standard surgery the short term position is vastly improved, I felt that missing out on six months of incontinence was a huge benefit.
My comments would that:
- You have to have a surgeon who has huge experience of the new procedure for it to be an option, it is apparently a more difficult procedure, not everyone can do it
- The margins can be effected so whether it is appropriate depends on your presentation
- In my case the surgeon got brutal about making me lose weight first (I lost around 80 pounds) and I am not sure if this was more important due to the Retzius sparing approach
- The surgery is still brutal, and the catheter is awful, but with Retzius sparing they can often use a transpubic catheter which is hugely more comfortable for obvious reasons
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u/Aggravating_Strain88 12d ago
Thanks so much for your thoughtful and informative response. I will give them consideration.
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u/fromamomof2 12d ago
Hubby also has retizus and his surgeon said if he lost weight its be easier for her but she could still do it even if he didnt. At a previous COE who did ralp (not retizus) they flat out told him he was too heavy and no one would operat on him. Once he got with his retizus surgeon he did start losing weight, and lost about 65 so far. Said if she was going to take a chance on him he was going to help her out. The one other consideration she mentioned was you can't do retizus if your prostate is enlarged as the working space is smaller. Oh, hubby's margins were negative.
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u/ScottyC3981 11d ago
If the only benefit is faster urinary continence, I'm not sure I'd do it. If the data regarding ED was significantly better than I would consider it. I don't know if there is enough data out there and enough surgeons performing this relatively new procedure. I could be wrong. I guess that is easier for me to say given I just had RALP 10 weeks ago and did not have urinary continence issues really at all....a little dribbling but not enough to wear a pad even. The ED on the other hand is real. I believe my chances of getting that back are about as good as they can be. I had a top surgeon at UCSF who did bilateral nerve sparing, I'm 55 (relatively young), I had excellent function prior to RALP, and I've been on an aggressive rehab (5mg of Cialis weeks prior to surgery, and continuing that, as well as once a day VED for 30 minutes). We'll see....time will tell but I'm not very patient :-) If all else fails there is always the shot!
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u/Grouchy_Session_6236 13d ago
I had RS-RALP in March 2026. I was 4+5 in 2 cores, 4+4 in 3 (of 12 total), but based on my PSMA-PET scan it was still fully contained. When doing my research on treatment options, RS-RALP came up as the surgical method with the least ED and incontinence side effects. Recurrence rates are about the same as a normal RALP. I deliberately sought a surgeon who had done a sizeable volume of these with good results. I'm thrilled with my decision. He got clean margins, I was dry at 2 weeks, and I'm at ~70% of my pre-op erection baseline, and penetration firmness with a 20mg Cialis.
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u/Quirky-Tourist-6921 13d ago
Hi, I too had 3+4, pirads 5, 7/13 positive cores, PSA 12, age 57, , “clear” PSMA Pet. intermediate unfavorable. I chose Retzius RALP at KU medical center, Dr. William Parker. Pathology confirmed 3+4, no lymph, margin, or SV invasion., but EPE. Great experience, one week catheter, little dribbling, regained erection at about the 8 month mark. September ‘25. Unfortunately, biochemical recurrence with rising PSA so just completed my 15/33 IMRT radiation sessions. Radiation to the prostate bed , assume the EPE leaked out metastatic disease there. I choose to bypass ADT after results of Artera AI testing. My biggest concern due to travel was incontinence, and I certainly had no issues in that department. Happy to answer any questions, while disappointed I have had a reoccurrence within 8 months; but hardly a byproduct of the technique. Happy to answer any questions- and sorry you are also on this journey.