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Our series represents a rigorous assessment of the complications associated with radical retropubic prostatectomy. It shows that in the hands of an experienced urological surgeon, this procedure is associated with minimal intraoperative and postoperative morbidity. Of the patients 98% had no intraoperative or postoperative complications. Our series enables appropriate contemporary comparisons to be made with laparoscopic prostatectomy and radiation therapy. This outcomes analysis implies that radical retropubic prostatectomy cannot be assumed to have greater morbidity than radiation therapy and it sets a high standard for those advocating laparoscopic radical prostatectomy.

Men who receive radiotherapy for localized prostate cancer have an increased risk of bladder cancer compared to patients undergoing radical prostatectomy and compared to the general population. The risk of rectal cancer is increased in patients who receive external beam radiotherapy compared to radical prostatectomy. Patients should be counseled appropriately regarding these risks.

Our series represents a rigorous assessment of the complications associated with radical retropubic prostatectomy. It shows that in the hands of an experienced urological surgeon, this procedure is associated with minimal intraoperative and postoperative morbidity. Of the patients 98% had no intraoperative or postoperative complications. Our series enables appropriate contemporary comparisons to be made with laparoscopic prostatectomy and radiation therapy. This outcomes analysis implies that radical retropubic prostatectomy cannot be assumed to have greater morbidity than radiation therapy and it sets a high standard for those advocating laparoscopic radical prostatectomy.

those not having a nerve-sparing procedure, neoadjuvant or adjuvant therapy within 6 months of RRP and a follow-up of < 6 months were excluded from the analyses. Erectile function was evaluated by the surgeon when possible or by an annual questionnaire. Potency was defined as erectile function sufficient for intercourse with or without a phosphodiesterase-5 inhibitor. RESULTSOf 619 men who had a bilateral and of 178 who had a unilateral nerve-sparing RRP, 72% and 53%, respectively, were potent. When stratifying by age groups ( ≤ 49, 50-59, 60-69 and ≥ 70 years) potency rates were 86%, 76%, 58% and 37%, respectively. Potency was more common after bilateral than unilateral nervesparing RRP in all age groups ( P < 0.001). Age, bilateral nerve-sparing (odds ratio 2.9) and surgeon experience were associated with potency in a multivariate analysis. CONCLUSIONCareful patient selection and meticulous surgical technique are essential to achieve the right balance between cancer control and morbidity. The patient's age, nerve-sparing RRP and the surgeon's experience were the significant predictors of return of potency after RRP. KEYWORDSradical prostatectomy, potency, nerve-sparing surgery Study Type -Therapy (case series) Level of Evidence 4 OBJECTIVETo report the return of erectile function in 1620 consecutive men after radical retropubic prostatectomy (RRP), chosen by half of men diagnosed with clinically localized prostate cancer, and the goal of which is to completely excise the tumour while preserving continence and erectile function.

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