Oncological outcomes and complications after salvage robotic-assisted laparoscopic radical prostatectomy (sRALP)

Twenty-three patients (38%) had persistent PSA. With a median follow-up of 82 months (interquartile range [IQR] 48-101 months), 16 patients (28%) had no BCR or start of androgen deprivation therapy (ADT). Twelve patients (20%) were deceased, 10 (17%) from PCa. Preoperative PSA was statistically significantly associated with persistent PSA (p = 0.01). International Society of Urological Pathology (ISUP) Grade Group 5 showed a statistically significant association with BCR (p = 0.01). Anastomosis leakage and strictures occurred in 27 (45%) and 15 patients (33%), respectively. Twenty-nine patients (48%) suffered severe urinary leakage, whilst 11 patients (24%) had moderate urinary leakage. Eleven patients (18%) received artificial urinary sphincters, and 10 patients (17%) underwent urinary diversion. Two patients suffered a grade 4 complication (sepsis), whilst 25 patients (41%) had grade 3 complications, most of which were related to intervention in the urinary system. Conclusion: Salvage RALP for radiorecurrent PCa has limited effect on oncological outcomes. Patients should be thoroughly informed about the high risk of urinary leakage and severe surgical complications.