{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:16:46Z","timestamp":1790875006633,"version":"4.1.0"},"reference-count":75,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Perioperative androgen-deprivation therapy (ADT) and androgen-receptor pathway inhibitors (ARPIs) are increasingly used in high-risk prostate cancer, yet patient-centred functional-recovery data after radical prostatectomy are scarce and rarely standardized. We assessed whether a smartphone-based digital monitoring pathway could characterize social-continence recovery and capture differences associated with a perioperative hormonal therapy (PHT) strategy after robot-assisted radical prostatectomy with pelvic lymph-node dissection (RARP + LND). Methods: In a two-centre consecutive cohort (n = 98) of men with high-risk, non-metastatic prostate cancer aligned with SUGAR and PROTEUS criteria, we compared upfront surgery (standard of care [SOC], n = 72) with a planned PHT strategy (ADT or ARPI, n = 26); all patients were urinary-continent preoperatively. Clinical data were prospective; patient-reported and patient-experience measures were captured through a routine-care digital platform (Betty Coaching application) delivering an identical prehabilitation\/rehabilitation pathway to both groups, with pre- and postoperative pelvic-floor muscle training performed by all patients. The primary endpoint was 6-month social continence (0\u20131 pad\/day), assessed by clinician and patient reports as co-primary sources. Differences are reported as risk differences with 95% confidence intervals (CIs). Results: At 6 weeks, no statistically clear difference was observed (clinician 66.2% vs. 56.5%; risk difference 9.7 percentage points, 95% CI \u221212 to 32). At 6 months, social continence was lower with PHT (clinician 87.1% vs. 65.0%, difference 22.1 points, 95% CI 2.6 to 44.7; patient 81.3% vs. 58.3%, 22.9 points, 95% CI 2.4 to 43.9), converging by 12 months (96.9% vs. 95.0%). Analgesic-free rates were lower with PHT on postoperative days (POD) 7 and 10. Conclusions: Digital monitoring captured granular recovery trajectories and identified a mid-term social-continence signal associated with PHT, compatible with a transient delay in recovery. These hypothesis-generating findings support embedding standardized digital functional-outcome monitoring in perioperative trials.<\/jats:p>","DOI":"10.3390\/diagnostics16172748","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:00:35Z","timestamp":1787821235000},"page":"2748","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Digital Patient-Reported Monitoring of Functional Recovery After Robot-Assisted Radical Prostatectomy in High-Risk Prostate Cancer Treated With or Without Perioperative Hormonal Therapy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5981-3802","authenticated-orcid":false,"given":"Bogdan Adrian","family":"Buhas","sequence":"first","affiliation":[{"name":"Urology Department, Groupe Hospitalier Diaconesses Croix Saint-Simon, 75020 Paris, France"},{"name":"Urology Department, Clinique La Croix du Sud, 31130 Quint-Fonsegrives, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Uleri","sequence":"additional","affiliation":[{"name":"Urology Department, Clinique La Croix du Sud, 31130 Quint-Fonsegrives, France"},{"name":"Urology Department, Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3831-1632","authenticated-orcid":false,"given":"Giorgio","family":"Calleris","sequence":"additional","affiliation":[{"name":"Urology Department, Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain"},{"name":"Urology Clinic, Department of Surgical Sciences, University of Turin and Citt\u00e0 della Salute e della Scienza, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilhem","family":"Roubaud","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Institut Bergoni\u00e9, 33000 Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marine","family":"Lesourd","sequence":"additional","affiliation":[{"name":"Urology Department, Clinique La Croix du Sud, 31130 Quint-Fonsegrives, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7768-8558","authenticated-orcid":false,"given":"Benjamin","family":"Prad\u00e8re","sequence":"additional","affiliation":[{"name":"Urology Department, Clinique La Croix du Sud, 31130 Quint-Fonsegrives, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Tollon","sequence":"additional","affiliation":[{"name":"Urology Department, Clinique La Croix du Sud, 31130 Quint-Fonsegrives, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4030-8299","authenticated-orcid":false,"given":"Damien","family":"Pouessel","sequence":"additional","affiliation":[{"name":"\u00a0Oncopole Claudius Regaud\u2014IUCT-Oncopole, University Toulouse III\u2014Paul Sabatier, 31062 Toulouse, France"},{"name":"Toulouse Cancer Research Centre, 31100 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Malavaud","sequence":"additional","affiliation":[{"name":"\u00a0Oncopole Claudius Regaud\u2014IUCT-Oncopole, University Toulouse III\u2014Paul Sabatier, 31062 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo\u00efc","family":"Mourey","sequence":"additional","affiliation":[{"name":"\u00a0Oncopole Claudius Regaud\u2014IUCT-Oncopole, University Toulouse III\u2014Paul Sabatier, 31062 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6004-2152","authenticated-orcid":false,"given":"Guillaume","family":"Ploussard","sequence":"additional","affiliation":[{"name":"Urology Department, Clinique La Croix du Sud, 31130 Quint-Fonsegrives, France"},{"name":"\u00a0Oncopole Claudius Regaud\u2014IUCT-Oncopole, University Toulouse III\u2014Paul Sabatier, 31062 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1002\/pros.24184","article-title":"Increasing Rates of NCCN High and Very High-risk Prostate Cancer versus Number of Prostate Biopsy Cores","volume":"81","author":"Wenzel","year":"2021","journal-title":"Prostate"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.eururo.2007.10.009","article-title":"An Analysis of Radical Prostatectomy in Advanced Stage and High-Grade Prostate Cancer","volume":"53","author":"Joniau","year":"2008","journal-title":"Eur. 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