Retzius sparing surgery

Incontinence is a common side-effect from surgery; retzius-sparing surgery minimizes that risk. Here are a couple of recent papers about this:
> https://pubmed.ncbi.nlm.nih.gov/36443438/
> https://pubmed.ncbi.nlm.nih.gov/35221232/

I had a retzius-sparing procedure known as the Hood Technique done at the Mayo in Rochester. Here is a link:
https://pubmed.ncbi.nlm.nih.gov/33067016/
My incontinence was minimal post catheter removal (1 to 2 ml leakage when taking a long walk for example) and I was completely pad free by six weeks. I'm not sure how widely it is utilized, but I would recommend choosing a surgeon who performs this procedure.

I am debating whether to have retzius or anterior hood technique. I am leaning toward retzius because of continence improvements. it appears more complicated, but continence appears to be a real issue for the standard anterior or extraperitoneal approaches.

Any comments on procedures used and continence results would be appreciated.

Like mn281, I had mine done with the anterior hood technique in Rochester. I also had some minor incontinence, but that was over by 8 weeks. Results with the anterior hood technique vs true Retzuis-sparing (posterior) seem to be similar. The posterior approach is more difficult to perform, so make sure you find someone who’s done it a lot. Also, I don’t think it can be done extraperitoneally. Mine was done extraperitoneally with a single-port robot, and the recovery was quite easy.

I honestly don’t know if I had either approach by Dr Samadi in 2019, but in describing his SMART technique to me he said that unlike most surgeons, “he comes over the top” which preserves continence. I am totally continent…but also totally impotent.
However my Gleason 4+3 Unfavorable had extensive perineural invasion in every single core so I told him to get the cancer out first and worry about potency second. Still here, NOT complaining…

Who did your procedure
at Mayo ?

Igor Frank did my surgery.

It was never discussed before surgery, but my surgical report indicates "space of Retzius sparing" as one of the components of the surgery. I have had zero incontinence since the moment of catheter removal. Good luck with your decision and outcome of your treatment!