Robot-assisted radical prostatectomy (RARP) is being increasingly utilised in treatment of prostate cancer (CaP). In addition to the minimally invasive nature, some of the reported perioperative advantages of RARP include lower surgical margin rate for intermediate-risk disease and high-risk disease, lower blood loss, lower risk of blood transfusions, and shorter hospital stays [1–7]. However, quality of life (QOL) in the longer term is more contentious. Clinical trials conducted in high volume centres depend on willing participants filling out questionnaires on a long-term basis in a ‘trial setting’ and thereby likely to be impacted by a variety of follow-up biases and may not accurately capture ‘real-life’ issues experienced by patients.

The delivery of quality care in cancer in the United States has been described as being in a state of crisis [1], while the cost of health care continues to grow to unsustainable levels [2]. Furthermore, the burden of bladder cancer in the United States is significant, with over 79,030 new cases estimated in 2017, and it remains the most prevalent malignancy of the urinary system with an estimated prevalence in the United States of 696,440 in 2014 [3]. The majority of incident cases represent nonmuscle invasive and low-grade disease.

In 2017, 161,360 estimated cases of prostate cancer (CaP) were diagnosed in the United States [1]. Men of high genetic West African ancestry (WAA) face disparities in CaP incidence worldwide. As a corollary, several studies have demonstrated that US Black men have increased risk of CaP diagnosis on prostate biopsy relative to White men [2]. It is unclear whether this is predominantly attributable to socioeconomic or biologic factors [3,4].