Urology Book

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Radical Prostatectomy

Aka: Radical Prostatectomy
  1. Indications: Prostate Cancer
    1. Patient age under 70 years
    2. Life Expectancy over 10 years
    3. Tumor confined to Prostate Gland
  2. Technique
    1. Entire Prostate excised
    2. Urethra and Bladder reanastomosed
  3. Advantages
    1. Best chance for long-term Prostate Cancer cure
    2. Prostate Cancer Staging is accurate
    3. Local Prostate Cancer controlled best
  4. Disadvantages
    1. Deep venous thrombosis risk
    2. Urethral stricture risk
    3. Urinary Incontinence following Prostatectomy
      1. Mild Stress Incontinence (1 pad per day): 14%
      2. Complete Incontinence: 1.5%
    4. Impotence following Prostatectomy
      1. Ages 40 to 50 years: 0%
      2. Ages 51 to 60 years: 45%
      3. Age over 70 years: 100%
  5. Efficacy
    1. Overall cure of Prostate Cancer: 60 to 70%
  6. Monitoring after Prostatectomy
    1. PSA > 0.1 ng suggests Prostate Cancer recurrence
  7. Course
    1. Hospitalization for 2-3 days postoperative
    2. Full activity within 1 month of surgery
  8. References
    1. Naitoh (1998) Am Fam Physician 57(7):1531-9 [PubMed]

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