adopted to define biochemical recurrence (BCR). Pathological and medium-term oncological outcomes were investigated, employing Mann-Whitney, Pearson Chi-square and Log rank test. Results: Pre- and post-sRP features are shown inTable 1. LR- and HR- patients were similar considering age at sRP and follow-up duration, but LR-ones demonstrated significantly better outcomes in terms of ISUP grading, pT staging, nodal involvement, proportion of positive surgical margins at sRP histology. Figure 1 reports Kaplan-Meier plots for BCR-free, overall and cancer-specific survival. 5y- BCR-free survival was 0.80 ± 0.06 and 0.52 ± 0.08 in LR- and HR-patients, respectively. Interestingly, because of up- and down-grading, pre-sRP biopsy and staging was less accurate in predicting BCR- free survival if compared to sRP pathology results. Conclusions: Patients with favorable risk profile showed promising oncological outcomes after sRP. Nearly 4 out of 5 men fully adherent to EAU recommendations were disease-free at 5 years. A potentially- curative surgical salvage treatment should therefore be taken into account after an accurate grading and staging at BCR. SC247 Risk factors for development a symptomatic lymphocele after lymph node dissection in a radical robotic prostatectomy: experience from a single center S. Sforza, R. Tellini, A.A. Grosso, C. Zaccaro, L. Viola, F. Di Maida, A. Mari, G. Cito, A. Cocci, S. Scelzi, M. Carini, A. Minervini, L. Masieri (Firenze) Introduction: Robot-assisted radical prostatectomy (RARP) has been established as first-line surgical therapy for organ-confined prostate cancer (PCa): pelvic lymph node dissection (PLND) is recommended in case of intermediate and high-risk localized PCa however symptom- atic lymphocele (SL) formation following PLND is a common complication but no certain clinical and surgical predictors of SL have been found yet in the robotic era. The aim of this study was to identify clinical and surgical predictors of SL after RARP and PLND. Materials and methods: We retrospectively evaluated all consecutive patients undergone RARP and PLND from 01/2017 to 06/2019 at our center. All procedures were performed by experienced robotic surgeons. All features of patients without SL (group A) were compared to those of patients with SL (group B). Results: Overall, 285 patients were submitted to RARP and PLND. After excluding 3 patients who experienced anastomotic leakage, 282 were divided into two groups according to the development of SL: 21 patients (7.5%) developed SL after surgery and constituted the group B; 261 patients did not develop SL and constituted group A. Median BMI was 25.8 (IQR: 23.1–28.3) in group A and a median of 30.4 (IQR: 30.1– 31) in group B was reported (p < 0.01). Moreover, in group A 22 patients (8.4%) underwent to previous vascular surgery or had a peripheric vascular/lymphatic disease while 5 patients in group B (23.8%) presented the same type of comorbidity or surgery with a significant statistically different (p = 0.02). Overall, there were no significant differences among the two groups considering all the other preoperative factors. We noted a statistically significative difference considering lymphadenectomy technique (p = 0.04): 42.3% of patients in group A underwent lymphadenectomy by extended use of clips instead 19% of patients in group B underwent the same technique; in 48 patients of group A (18.5%) bipolar technique was used while it was used in 8 patients of group B (38.1%). We didn’t record a statistical correlation to the development of SL considering drainage placement, different pathological stages of tumors, number of removed lymph nodes, positive lymph nodes discovered or ISUP grade. Length of stay was significantly higher in the group B compared to group A (3, IQR 3– 4 vs 5, IQR 4–7; p = 0.01) as the readmission rate with 9 patients in the group B (42.9%) and 4 patients (1.5%) in the group A. 7 (33%) SL required an antibiotics treatment while 14 patients (67%) performed a drainage US/CT guided. At MVA, including BMI>30, previous vascular surgery, lymphadenectomy technique and template, only BMI > 30 was found to be a predictorof SL (OR 27.1; CI 8.6–85.0; p < 0.001). Conclusions: In our experience, BMI >30 was a significant predictor for the development SL in patients submitted to RARP and PLND for PCa. Larger series are needed to confirm our findings and to elaborate on a clinical nomogram for the prediction of SF in this setting. SC248 Surgical determinants of immediate urinary continence in patients submitted to robotic- assisted radical prostatectomy F. Dotta, A. Pacchetti, G. Mantica, D. De Marchi, M. Borghesi, F. Gaboardi, C. Terrone,N. Suardi (Genova) Introduction: Preservation of urinary continence (UC) represents one of the goals of robot-assisted radical prostatectomy (RARP) and several preoperative factors have been demonstrated to impact on post- operative UC. However, there is a significant variability in UC recovery rates and the relationship between intraoperative feedback and postoperative results has not been demonstrated. We tested the impact of different surgical steps on immediate urinary continence (IUC) based on surgical video reviews in order to investigate intraoperative parameters predicting IUC. Materials and methods: Videos of consecutive RARP patients performed by a single experienced surgeon were analyzed by 2 surgeons with experience in RARP, blinded to the postoperative functional results. The following intraoperative surgical steps were rated: bladder neck (BN) preservation (defined according to the Prostatectomy Assessment and Competence Evaluation – PACE scoring system); urethral stump length (USL) after apical dissection (3-points scale); urethral wall thickness (UWT) after section of the urethra (2- point scale based on the visual preservation of both the circular and longitudinal walls). IUC was defined as the use of no pads 7 days after catheter removal. T-test and Chi-square tests were used for compar- isons according to preoperative and intraoperative variables. Univariable and multivariable logistic regression analyses were used to identify independent predictors of IUC among the evaluated surgical steps. Covariates consisted of patients’ age and nerve- sparing (NS) technique, as defined by the operating surgeon. Results: 126 patients were analyzed. Median (IQR) age was 63,6 (57.6; 68.9) years. NS status was bilateral in 68 (54%), unilateral in 35 (27.8%) and non-NS in 23 (18.3%) patients. IUC was obtained in 84 patients (66.7%). Mean and median BN PACE scorewas 4.32 and 4. Mean and median USL was 1.99 and 2, and mean and median UWT was 1.68 and 2. Patients with IUC were younger than non-IUC patients (mean age 62.7 vs 66.9; p = 0.01). The frequency of bilateral NS procedures was higher in IUC vs. non-IUC patients (60. 7 vs 32.1%). Patients with IUC received higher UWT scores than pts without IUC (1.72 vs 1.42; p = 0.01) while no significant difference was seen in BN (p = 0.42) nor in USL (p = 0.48) scores among the 2 groups. At univariable logistic regression analyses age (OR: 0.92; p = 0.01), NS status (OR: 2.46; p = 0.002), and UWT score (OR: 2.24; p = 0.02) were significantly associated with higher IUC. Neither BN nor USL were significantly associated with IUC (p = 0.42 and p = 0.47). At multivariable logistic regression analyses, after adjusting for patients’ age, NS status (OR: 2.15; p = 0.03) and UWT score (OR: 2.37; p = 0.02) represented independent predictors of IUC. Conclusions: Video-analyses of RARP with surgical steps scoring may represent a useful tool to predict IUC. USL after apical dissection as well as the extent of BN dissection did not show significant correlation with IUC. The preservation of UWTrepresents a key for recovery of IUC. European Urology Open Science 20(S2) (2020); S31–S192 S146