Radical retropubie prostatectomy: a review of 8 years of experience

ABSTRACT

Different modalities for treating prostate cancer are evolving worldwide. Radical prostatectomy is still ranking on top of the list for organ- confined disease. This study was conducted out to describe the indications, surgical technique, complications and outcome of radical retropubic prostatectomy for prostate cancer over an 8- year period at Prince Hussein Center of Urology and Organ Transplant, King Hussein Medical Center. Between August 1999 and June 2007, a total of 81 patients [age range 50-68 years] underwent radical retropubic prostatectomy for organ confined prostate cancer [stage Tla-T2c] based on Prostate Specific Antigen values, histopathology reports [Gleason Score 4-7] and negative metastatic work up. Follow-up of these patients ranged between 1 and 7 years. The medical records of these patients were reviewed, and analyzed regarding indications, surgical technique, complications, and outcome. None of the patients had pelvic lymph node involvement, and surgery accomplished in 2.5-3.5 hours. Estimated blood loss was between 500 and 2000ml. Early continence, within 4 weeks after surgery, was achieved in 51/81 [62.9%] and in 98.7% after one year. Potency within 1 year was achieved in 42 patients [51.8%], but with medications this number reached 52 [64%]. Margin positive histopathology reports were seen in 12 patients [14.8%] warranting further treatment with either radiotherapy or hormonal therapy. Mortality rate in the study group was 2.5% as a result of disease progression and dissemination. Radical Retropubic Prostatectomy stands the gold standard method of treatment for localized prostate cancer with excellent results in cure and tumor control