Radical perineal prostatectomy versus radical retropubic prostatectomy after previous prostate surgery: surgical and functional outcomes.
OBJECTIVE
We performed a retrospective review of our database to evaluate surgical and functional outcomes in men undergoing radical perineal prostatectomy (RPP) versus radical retropubic prostatectomy (RRP) after previous prostate surgery.


METHODS
A total of 616 men underwent RPP at our institution. A retrospective review of these patients showed that 59 had a history of previous surgical approach for benign prostatic hyperplasia. A second group of 59 match-paired prostate cancer patients with a history of previous prostate surgery, treated by RRP, were recruited in the our database and was used as control group. All patients were followed up at 3, 6 and 12 months and evaluated during an office evaluation with regard to urinary incontinence and erectile dysfunction.


RESULTS
Overall complete continence was achieved in 49 (83%), 51 (86.4%) and 55 (93.2%) RPP patients at 3, 6 and 12 months, respectively, versus 39 (66.1%), 42 (71.1%) and 47 (79.6%) RRP patients, respectively (p = 0.03, p = 0.04 and p = 0.03, respectively). No significant difference was reported between the two groups in the overall percentage of preserved normal erectile function.


CONCLUSIONS
Radical prostatectomy in patients with previous prostate surgery should be performed with the transperineal rather than the retropubic approach.
Urology Unit, Fatebenefratelli Hospital Naples, Naples, Italy.
Vittorio
V
Imperatore
Francesco
F
Cantiello
Ferdinando
F
Fusco
Mariateresa
M
Iannuzzo
Sergio
S
Di Meo
Ciro
C
Imbimbo
Vincenzo
V
Mirone
D000368:Aged; D016022:Case-Control Studies; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000379:methods*