[The morbidity of radical prostatectomy using a retropubic approach: a series of 150 cases].
The authors studied the morbidity of retropubic radical prostatectomy in 150 patients operated between December 1983 and March 1993. The perioperative mortality was zero. A rectal injury occurred in 3 cases (2%) and was repaired immediately without colostomy. The median operative blood loss was 1,500 ml. 36.6% of cases developed perioperative complications. 8% of early postoperative complications (< 1 month) required reoperation. Major complications (thromboembolic and septic) were observed in 3.2% of cases. The late postoperative complications included fibrous stenosis of the urethrovesical anastomosis in 12% of cases with a median time to onset of 4 months: 3.6% of patients developed an anastomotic stenosis due to local recurrence. 12.6% of cases developed persistent urinary incontinence (6.6% of minor incontinence, 5.3% of moderate incontinence and 0.7% of severe incontinence). Incontinence was more frequent (p < 0.05) among the first 75 patients of the series. Erectile function was preserved in 19.8% of patients. The incidence of post-operative impotence was significantly lower (p < 0.01) in patients under the age of 60 years (65% vs 94.8%). Radical prostatectomy, considered to be the most appropriate treatment for localised prostatic cancer, can now be performed with acceptable morbidity.
Bretheau
D
D
Département d'Urologie, C.M.C. de la Porte de Choisy, Paris.
Bochereau
G
G
Veillon
B
B
Brisset
J M
JM
Vallancien
G
G
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D016063:Blood Loss, Surgical; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery; D012007:Rectum / Q000293:injuries / Q000601:surgery; D014522:Urethral Diseases / Q000209:etiology; D014524:Urethral Obstruction / Q000209:etiology; D014525:Urethral Stricture / Q000209:etiology; D001747:Urinary Bladder Fistula / Q000209:etiology; D014548:Urinary Fistula / Q000209:etiology; D014549:Urinary Incontinence / Q000209:etiology
La morbidité de la prostatectomie radicale par voie rétropubienne: une expérience de 150 cas.