Robotic-assisted radical prostatectomy (RARP) is a safe treatment widely used for localized prostate cancer [1]. Other treatment alternatives are available, with the most widely chosen options including external beam radiotherapy and brachytherapy. Factors such as age, preoperative urinary symptoms, cancer stage and grade, and prostate size can influence the suitability of one approach over another. Individuals with larger prostates might not be ideal candidates for nonsurgical treatments. This is particularly pertinent as external beam radiotherapy and brachytherapy may lead to urinary complications linked to prostate size, thereby rendering them less advisable for this specific group [2], [3].

To address this issue, recent studies have explored prostate size as a potential factor for predicting oncological and functional outcomes following prostatectomy [4], [5], [6], [7]. RARP for larger prostates is associated with greater blood loss, longer operative times, and delayed recovery of continence [8], [9], [10]. However, the greatest limitation in these studies was the low number of patients, especially with large prostates >100 g. The aim of our study was to investigate the effect of prostate size on functional and oncological outcomes of RARP in a very large cohort. To the best of our knowledge, this is the largest cohort of patients in the literature covering this subject.