Robotic-assisted radical prostatectomy (RARP) has become the leading approach for radical prostatectomy driven by innovations aimed at improving functional and oncological outcomes. The initial advancement in this field was transperitoneal multiport robotics, which has since undergone numerous technical modifications. These enhancements include the development of extraperitoneal, transperineal, and transvesical approaches to radical prostatectomy, greatly facilitated by the advent of the Single Port (SP) robot. This review offers a comprehensive analysis of these evolving techniques and their impact on RARP. Additionally, we explore the transformative role of artificial intelligence (AI) in digitizing robotic prostatectomy. AI advancements, particularly in automated surgical video analysis using computer vision technology, are unprecedented in their scope. These developments hold the potential to revolutionize surgeon feedback and assessment and transform surgical documentation, and they could lay the groundwork for real-time AI decision support during surgical procedures in the future. Furthermore, we discuss future robotic platforms and their potential to further enhance the field of RARP. Overall, the field of minimally invasive radical prostatectomy for prostate cancer has been an incubator of innovation over the last two decades. This review focuses on some recent developments in robotic prostatectomy, provides an overview of the next frontier in AI innovation during prostate cancer surgery, and highlights novel robotic platforms that may play an increasing role in prostate cancer surgery in the future.

The bulbar urethra is the most common site of stricture disease for which urethroplasty remains standard of care. A decrease in trauma as an etiology in the developed world and concerns regarding sexual dysfunction related to transection of the corpus spongiosum have placed a renewed emphasis on non-transecting urethroplasty techniques. Here, we present our surgical algorithm with emphasis on non-transecting techniques for bulbar urethral stricture disease and review the current state of literature comparing transecting to non-transecting approaches in order to provide guidance to practitioners on patient selection, counseling, and technique.

Purpose: Lower urinary tract symptoms among adult men can significantly impact quality of life. We evaluated complications based on prostate size following plasmakinetic enucleation of the prostate. Materials and Methods: Patients were grouped into the small prostate group (SPG, 75 g) based on preoperative imaging. Patient data on demographics, comorbidities, preoperative international prostate symptom score (IPSS), bother index (BI), prostate-specific antigen (PSA) if indicated, postvoid residual volume (PVR), indwelling catheter or self-catheterization status, and any prior surgical intervention were evaluated. Postoperative IPSS, BI, and PVR values were assessed at 6 weeks, 4 months, and yearly. Postoperative urge urinary incontinence (UUI), stress urinary incontinence (SUI), and pad use were assessed. Results: Between September 2015 and December 2020, 296 patients who underwent bipolar enucleation with minimum follow-up of 4 months were evaluated. Postoperative IPSS, BI, PVR, and PSA values at all time points were significantly decreased compared with preoperative values ( p < 0.05). There was no significant difference in the complications between groups. Univariable and multivariable analysis found that size <75 g was predictive of stricture formation and bladder neck contracture (BNC). UUI was more common at 6 weeks in the SPG, and SUI was more common at 6 weeks in the LPG, but no difference was noted at the 4-month and 1-year time points. Pad use was equal between the two groups at all time points. Conclusions: Plasmakinetic enucleation of the prostate provides an effective treatment option for prostates of all sizes; however, prostates 75 g.