To compare the efficacy and safety between robotic-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for low or intermediate-risk prostate cancer (PCa).

The data of 70 patients with low or intermediate-risk PCa including 35 patients who received RARP (RARP group) and another 35 patients who received LRP (LRP group) from October 2019 to January 2024 in Urology Department of Shenzhen Second People's Hospital were retrospectively analyzed. Propensity score matching (PSM) was conducted. According to D'Amico risk grouping, all patients were classified as low or intermediate-risk PCa. Both surgical procedures were performed via a transabdominal approach. There were no significant differences between the two groups in the preoperative clinical data including age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, prostate volume, prostate specific antigen (PSA) level, biopsy Gleason score, clinical stage and D'Amico risk grouping (P>0.05). All patients were followed up for at least 12 months. The intraoperative, postoperative parameters and functional recovery of the two groups were compared.

Compared with the LRP group, the RARP group had longer operation time (P<0.05) but less intraoperative blood loss (P<0.05). The continence recovery in the RARP group was significantly higher than that in the LRP group at 1, 2 months after operation (P<0.05). The sexual function recovery of the RARP group was significantly higher than that of the LRP group at 6, 9 and 12 months after operation (P<0.05). All patients recovered continence at 12 months after operation. None of the patients had biochemical recurrence during the follow-up period.

Compared with laparoscopic surgery, robotic surgery can reduce the risk of bleeding in radical prostatectomy for low or intermediate-risk PCa. At the same time, robotic surgery has more advantages in early postoperative continence and sexual function recovery.