Evaluation of complications and results in a contemporary series of 300 consecutive radical retropubic prostatectomies with the anatomic approach at a single institution.
OBJECTIVE
To evaluate the complications and results of radical retropubic prostatectomy with the anatomic approach, at our center, to allow a comparison with published studies and precise patient counseling.


METHODS
We reviewed the charts and records of the follow-up visits of all patients who consecutively underwent radical retropubic prostatectomy for clinically intracapsular prostate cancer between March 1997 and February 2002.


RESULTS
The pathologic stage was pT0 in 4 patients (1.3%), pT2a in 83 (27.7%), pT2b in 116 (38.7%), pT3a in 52 (17.3%), pT3b in 38 (12.6%), and pT4 in the remaining 7 (2.4%). Extracapsular disease extension was present in 97 specimens (32.3%); it was associated with positive margins in 64 patients (21.3%). Intraoperative and postoperative complications were recorded in 19 patients (6.3%). Immediate surgical repair was necessary in 3 cases (1%) and delayed in 5 (1.7%). A stricture of the vesicourethral anastomosis was observed in 2 patients (0.7%). At a median follow-up of 29 months (range 6 to 57), a total of 262 patients (88.8%) was continent; 26 patients (8.8%) had stress incontinence, and 7 were incontinent (2.3%). Of 262 patients, 128 (48.2%) achieved continence within the first day of catheter removal.


CONCLUSIONS
Radical retropubic prostatectomy is associated with low complication rates; with the anatomic approach, a limited incidence of incontinence is attainable, consistent with major referral centers.
Urology Unit, Istituto Clinico Humanitas, Rozzano-Milano, Italy.
Massimo
M
Maffezzini
Mauro
M
Seveso
Gianluigi
G
Taverna
Guido
G
Giusti
Alessio
A
Benetti
Pierpaolo
P
Graziotti
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000601:surgery; D003376:Counseling / Q000379:methods; D007172:Erectile Dysfunction / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D014549:Urinary Incontinence / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000453:epidemiology
D017430:Prostate-Specific Antigen