A comparison of radical retropubic with perineal prostatectomy for localized prostate cancer within the Uniformed Services Urology Research Group

Lance, Raymond S.; Freidrichs, P.A.; Kane, Christopher J.; Powell, Curt R.; Pulos, Elizabeth; Moul, Judd W.; McLeod, David G.; Cornum, Rhonda L.; Thrasher, J. Brantley

doi:10.1046/j.1464-410x.2001.00023.x

Cited by 104 publications

(63 citation statements)

References 15 publications

(13 reference statements)

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“…Rectal injuries have been shown to occur more frequently in RPP than in RRP (22 the experience of the surgeon plays a role in the frequency of rectal injuries with very low rectal injury rates being reported by surgeons experienced in RPP (14). In fact, at our institution we have seen no rectal injuries within the last 5 years.…”

Section: Complicationsmentioning

confidence: 54%

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Case selection and outcome of radical perineal prostatectomy in localized prostate cancer

et al. 2003

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Radical prostatectomy continues to play a central role in the management of localized prostate cancer. The majority of patients diagnosed with prostate cancer will undergo radical prostatectomy. A decrease in the morbidity of this surgical procedure has been accomplished through an improved understanding of pelvic anatomy and a greater understanding of the natural history of prostate cancer. Recently, minimally invasive techniques have been applied to radical prostatectomy (laparoscopic prostatectomy) in order to further decrease the morbidity of this operation. What remains to be determined is whether this approach confers the same long term surgical outcomes as the open approach. One method which offers known long term outcomes coupled with decreased morbidity is the radical perineal prostatectomy. The purpose of this paper is to review the criteria for patient selection as well as outcomes of the radical perineal prostatectomy.

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Section: Complicationsmentioning

confidence: 54%

“…The largest comparison trial to date is that of the Uniformed Service Urology Research Group (22). This was a pooled analysis of data from 5 military institutions of 1,698 men who had undergone radical prostatectomies between 1988 and 1997.…”

Section: Discussionmentioning

confidence: 99%

Case selection and outcome of radical perineal prostatectomy in localized prostate cancer

et al. 2003

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“…The predominant Gleason score, when staging prostate cancer in a homogenous group and with probable localized disease (PSA ≤ 10 ng/ml), is predominantly 3.3, as observed by Lance et al (4) and Doblet et al (5) . As to operative time, perineal approach is briefer due to anatomic reasons, since it provides direct access to the prostate.…”

Section: Introductionmentioning

confidence: 65%

“…Rectal lesion is described in all studies on the use of perineal approach in prostatectomy, with incidences of 4.9% in Lance et al (4) and of 1% in Hiraoka et al (10) . Gillitzer et al (8) reported up to 3% rectal lesion when prostatectomy was performed by an experienced surgeon and up to 11% during the learning curve.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis of radical prostatectomy techniques using perineal or suprapubic approach in the treatment of localized prostate cancer

Amorim

Cruz

Veloso

et al. 2010

Einstein (São Paulo)

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Objective: To compare the results of radical prostatectomy by perineal and suprapubic approaches as to operative time, procedure costs, and surgical site complications. Methods: The medical records of localized prostate cancer patients (PSA ≤ 10 ng/ml and Gleason score ≤ 6) were analyzed. Fifty-five patients were submitted to radical prostatectomy by perineal approach and 54 via suprapubic approach. results: There were statistical differences between groups as to operative time (p < 0.05); for perineal approach it was in average 114 minutes (SD ± 0.03) and for suprapubic approach, an average of 167 minutes (SD ± 0.041). Prostatectomy via perineal approach resulted in 11 cases of surgical complications, and suprapubic approach, 3 cases. conclusions: Radical prostatectomy via perineal approach took less time at a lower cost as compared to the suprapubic approach. However, there were more complications in patients submitted to perineal approach, mainly rectal lesions.Keywords: Prostatectomy/methods; Prostatectomy/economics; Prostatectomy/adverse effects; Prostatic neoplasms reSUMO Objetivo: Comparar os resultados da prostatectomia radical por acesso perineal e por via suprapúbica quanto ao tempo operatório, custo de realização do procedimento e complicações do sítio cirúrgico. Métodos: Foram analisados os prontuários de pacientes com câncer de próstata localizados (PSA ≤ 10 ng/ml e escore de Gleason ≤ 6) sendo 55 submetidos à técnica de prostatectomia perineal e 54 à técnica suprapúbica (PRSP). resultados: Houve diferença estatística entre os grupos quanto ao tempo operatório (p < 0,05). O tempo médio para a realização de todo o ato operatório por acesso perineal foi 114 minutos em média (DP ± 0,03) e de 167 minutos em média (DP ± 0,041) quando empregado o acesso suprapúbico. O índice de complicações cirúrgicas decorrentes das prostatectomias realizadas foi de 11 casos na prostatectomia radical perineal e de 3 casos submetidos à técnica suprapúbica. conclusões: A prostatectomia radical pelo acesso perineal foi realizada em menor tempo com menor custo do procedimento quando comparada à operação realizada pelo acesso suprapúbico. Entretanto, relacionou-se a maior incidência de complicações em comparação ao acesso suprapúbico, principalmente com relação à lesão retal.

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“…The perineal approach avoids the "Veil of Mystery," and the risk of injuring neurovascular bundle is lessened (2,4). In addition, reports have demonstrated comparable results between RPP and RRP (7,19). Furthermore, RPP is much less expensive and faster to perform, and does not require a new technical set of operative skills, thereby, minimizing the learning curve (2,4).…”

Section: Commentsmentioning

confidence: 99%

Radical perineal prostatectomy and early continence: outcomes after 120 cases

Albayrak¹,

Cangüven²,

Göktaş³

et al. 2010

Int. braz j urol.

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Purpose: Evaluate the results of urinary continence on patients who had undergone radical perineal prostatectomy (RPP) for clinically localized prostate cancer. Materials and Methods:We analyzed the continence data of 120 patients with pathology of cT1-cT2N0M0 prostate cancer and who had undergone RPP. Continence was assessed on the day of catheter removal, at the end of the first and third month, and the first year postoperatively. The patients who were continent immediately after catheter removal were classified in the group of "immediately continent" while the patients who became continent during the 3 postoperative months were classified as "early continent." Results: Mean duration of catheterization was 10 (10-25) days. Of 120 patients, 44 (36.7%) were immediately continent. At the end of the first and third months, 65 (54.1%) and 87 (72.5%), respectively, were early continent. At the one-year follow-up, 95.3% of 107 cases whose one-year follow-up data were available were continent. When the relationship between patients' age and continence was analyzed, it was found that the early continence rates were 77.7% (7/9), 73.3% (33/45), 73.4% (36/49), and 64.7% (11/17) in the groups of ≤ 49, 50-59, 60-69, and ≥ 70 years, respectively (p = 0.68). Conclusions: The majority of patients who underwent RPP rapidly regained continence within 3 months. RPP is an exceptional alternative approach for radical surgery in the treatment of localized prostate cancer.

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A comparison of radical retropubic with perineal prostatectomy for localized prostate cancer within the Uniformed Services Urology Research Group

Cited by 104 publications

References 15 publications

Case selection and outcome of radical perineal prostatectomy in localized prostate cancer

Case selection and outcome of radical perineal prostatectomy in localized prostate cancer

Comparative analysis of radical prostatectomy techniques using perineal or suprapubic approach in the treatment of localized prostate cancer

Radical perineal prostatectomy and early continence: outcomes after 120 cases

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