LAUSR

secondary treatment (e.g., pelvic radiation). RESULTS: Key surgical steps of EPUP include: 1) athermal division of the thin fascial covering over the urethra-prostate junction; 2) urethral smooth muscle longitudinal fiber identification; 3) and urethral smooth muscle extension using mostly blunt dissection. EPUP dissections typically spanned the majority of the prostate (Figure), with a median IUL preserved of 4.0 cm (range 2.0-7.0 cm). Median time to 0-1 ppd and 0 ppd was immediate and 2 months, respectively; and 28% of patients achieved immediate recovery of 0 ppd upon Foley removal. Apical positive margins were infrequent (11%) and only 2 patients (1.6%) had a positive urethral fossa margin. Over a median follow up of 24 months (range 6-63), 9%, 15% and 17% of patients had AUA BF, NCCN BF and RRP failure, respectively. Both patients with a positive urethral fossa margin remained disease-free with an undetectable PSA (without secondary treatment) after 31 and 29 months of follow up. CONCLUSIONS: EPUP is technically feasible during RARP and associated with rapid continence recovery, without evidence of early oncologic compromise. Future investigation into the functional benefit and longer term oncologic safety of EPUP is warranted.