Radical prostatectomy (RP) stands as a widely recognized and established surgical management option for localized prostate cancer [1], [2]. Although the advent of the robotic approach has provided enhanced visualization, superior dexterity, and improved precision compared with open and laparoscopic approaches, it is crucial to underscore that the pursuit of continuous quality improvement remains paramount in achieving surgical excellence, irrespective of the chosen surgical approach to ensure improved outcomes [2]. Ernest Amory Codman [3] was pioneering in the field of surgical quality improvements. It was his belief that high-quality care did not derive from fancy equipment, but rather from self-assessment by health care professionals. With this philosophy, advocating prospective tracking of patient outcomes to improve the quality of health care, Codman [3] has formed the basis of today’s quality assurance programs (QAPs) [4], [5].

Contemporary QAPs are structured programs in which health care professionals critically review patient outcomes, and continuously analyze and discuss their results [6]. Through the use of continuous and short-cycled processes of data registration, evaluation, and adaptation, improvements in outcomes are sought. Although QAPs have made their way into health care over the past decades, their implementation in urological practice is a relatively recent development [6], [7]. Currently, the concept of QAPs is not universally standardized, and there is no consensus on its ideal form. Various conceptually different QAPs have been proposed, specifically within the context of RP, all aiming to improve both oncological and functional outcomes [6], [8], [9], [10].

In this review, we will therefore systematically assess the current literature regarding the implementation of surgical QAPs covering RP. Particular emphasis will be placed on outlining its impact on improving oncological and functional outcomes after RP, expressed in terms of positive surgical margins (PSMs), urine continence, erectile function, complications, and hospital readmissions.