Most of the surgeons dealing with the surgical treatmentof prostate cancer apply a popularised kindof posterior reconstruction known as the Roccostitch. It is an approximation of the remnants of therectourethral muscles with the remnants of the Denonvilliers'fascia (DF). Originally, this techniquewas implemented in a retropubic radical prostatectomy,and in multiple published studies, authorsconcluded that it allows improvement of early confidenceafter surgery. Concurrently, multiple reportshighlight a concept that DF is too weak to give sufficientsupport for a posterior reconstruction. Followingthis idea, some other concepts are being applied,for example, reapproximation of the urethra withthe tendinous arch of the levator ani. Reapproximationof the urethral stump and the vesical openingpromotes a tension-free anastomosis, allows achievinga longer membranous urethra, and createsa firm posterior support. After the transition froma classic laparoscopy to robot-assisted radical prostatectomies in our institution, an increased numberof cases of vesico-urethral anastomosis strictures(VUAS) were noted. In most cases, polymer clipmigration was revealed during endoscopic inspection.VUAS is not easy to treat and entails a riskof debilitating complications. That has promptedthe authors to look for a solution. Our modificationapplies an approximation of the urethral stumpwith the vesical opening using a barbed running suturein two layers. The first layer is an equivalentof a Rocco stitch, which brings together the posterioraspect of the urethral stump and the externalaspect of the bladder neck. After an adequatetightening of this first line of the sutures, an additionallayer of the same running suture is placedto precisely reapproximate the mucosa of the urethraand the bladder opening. This reconstructionis followed by a regular vesico-urethral anastomosisusing a standard van Velthoven technique.In the period from March 2020 to March 2024,there were 291 robot-assisted radical prostatectomies(RARP) performed in our Institution. The first50 RARP were not included in the study as a learningcurve group. In our retrospective observationalstudy, we have compared an initial group of patient with the use of the classic Rocco stitch (n = 135)with a study group (n = 156) where the aforementionedmodification of the posterior reconstructionwas applied. VUAS was noted in 9 cases (6.67%)in the initial group, and 3 (1.92%) in the studygroup. The endoscopic inspection revealed 7 caseswith clip migration after the classic Rocco stitchand 1 after the modified method. In our opinion,such modification can be a valuable option for therobot assisted VUA due to many factors: a reductionof tension in the anastomosis, an increasednumber of tissue layers that may promote healingthrough an improved blood supply and create separationof the healthy tissue from the polymer clips,and finally a reduction of VUAS. Furthermore,the mucosa approximation and the multilayer posteriorplate can guarantee an unobstructed catheterizationif any unexpected catheter loss happens.Nevertheless, further studies are required fora stronger confirmation.