Anastomotic leaks and catheter time after salvage robot-assisted radical prostatectomy

Since Mador et al. (1) published the first series of salvage radical prostatectomy (SRP), this procedure has been increasingly used in patients with radio-recurrent prostate cancer (PCa) (2). Nonetheless, radiotherapy-induced fibrosis and changes in periprostatic tissues associated with the delivery of a primary treatment make SRP a challenging procedure even in the hands of experienced surgeons. As such, SRP is frequently associated with detrimental perioperative outcomes as compared to primary open or minimally invasive prostatectomies (3). Recent studies suggest that the advantages associated with the robotic approach might play a major role in the context of SRP, where optical magnification and reduced bleeding would facilitate tissue manipulation and the ability to perform a watertight vesicourethral anastomosis (VUA) (4). Nevertheless, the rate of perioperative complications for this surgical procedure remains high even in men treated with minimally invasive surgery and more than one out of four of patients experience anastomotic leaks (5).