A novel pelvis-prostate model RRRIV for predicting surgical complexity in laparoscopic radical prostatectomy

Objective This study aims to develop and validate a comprehensive scoring system based on anatomical and clinical parameters to predict surgery duration, operative blood loss, and urinary control in patients undergoing laparoscopic radical prostatectomy (LRP). Methods This retrospective analysis included 361 patients with prostate cancer who underwent surgery performed by Xudong Yao. The study evaluated the correlation of variables such as height/weight ratio (HWR), prostate/pelvis ratio (PPR), retzius space (RS) size, intravesical prostatic protrusion (IPP), and prostate volume (PV). Based on these factors, the RRRIV scoring system was developed. The correlation between these variables and key outcomes (surgery duration, operative blood loss, and urinary function recovery) was then assessed in relation to the RRRIV score. Results Correlation analysis revealed significant positive associations between the RRRIV score and operative time (95% CI = 0.229(0.129-0.325), p < 0.001), operative blood loss (95% CI = 0.305(0.209-0.386), p < 0.001), and recovery of urinary function (95% CI = 0.381(0.289-0.466), p < 0.001). Furthermore, intergroup comparison showed that the medium and high-risk groups had significantly greater intraoperative blood loss, longer operative duration, and delayed recovery of urinary continence compared to the low-risk group. For the primary outcomes, the model demonstrated good discrimination, with an area under the curve ≥0.6. Conclusions The RRRIV scoring system provides a reliable method for predicting surgery duration, intraoperative blood loss, and recovery of urinary function in LRP, aiding surgeons in making more informed decisions during preoperative planning and patient discussions.