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RESULTSWe enrolled 105 patients in the RRP and 103 in the RALP group; the two groups were comparable for all clinical and pathological variables, except median age. For RRP and RALP the respective median operative duration was 135 and 185 min ( P < 0.001), the intraoperative blood loss 500 and 300 mL ( P < 0.001) and postoperative transfusion rates 14% and 1.9% ( P < 0.01). There were complications in 9.7% and 10.4% of the patients ( P = 0.854) after RRP and RALP, respectively; the positive surgical margin rates in pT2 cancers were 12.2% and 11.7% ( P = 0.70). For urinary continence, 41% of patients having RRP and 68.9% of those having RALP were continent at catheter removal ( P < 0.001). The 12-month continence rates were 88% after RRP and 97% after RALP ( P = 0.01), with the mean time to continence being 75 and 25 days ( P < 0.001), respectively. At the 12-month follow-up, 20 of 41 patients having bilateral nerve-sparing RRP (49%) and 52 of 64 having bilateral nerve-sparing RALP (81%) ( P < 0.001) had recovery of erectile function. CONCLUSIONS

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When applying a standardized methodology to report early morbidity, about 50% of patients undergoing radical cystectomy had complications within 3 months of surgery. Although most complications were minor, about 13% of patients experienced grade 3 to 5 events, resulting in a 3-month mortality rate of 3%. American Society of Anesthesiologists score was significantly associated with major complications, while on subgroup analysis in patients who received an orthotopic ileal neobladder female gender was also an independent predictor of major complications.