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

Abstract

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.

Retropubic versus perineal radical prostatectomy in early prostate cancer: Eight‐year experience

“…Holzbeierlein et al in 2003 confirmed that radical perineal prostatectomy offers outcomes similar to radical retropubic prostatectomy. Its advantages included decreased pain, blood loss, and convalescence [11]. In addition, it is the optimal approach for obese patients, patients with prior pelvic surgery, or patients with prior pelvic radiation.…”

“…In similar populations of patients, RPP offered equivalent organ-confined, marginpositive and biochemical recurrence rates to RRP, while causing significantly less blood loss [9,10]. Holzbeierlein et al in 2003 confirmed that radical perineal prostatectomy offers outcomes similar to radical retropubic prostatectomy. Its advantages included decreased pain, blood loss, and convalescence [11].…”

“…We evaluated that perineal prostatectomy has the advantage of minimal blood loss, shorter catheterization time, and earlier discharge from hospital as reported by Sullivan et al in 2000 [33], Holzbeierlein et al [11], and Zuo and Hiraoka in 2003 [14].…”

“…There is no prospective randomized study RRP versus RPP. Concerning to the clinical results [11][12][13][14][15][16], it seems very useful and interesting perform a prospective randomized study as we did.…”

UROLOGICAL ONCOLOGY Radical perineal prostatectomy – the contemporary resurgence of a genuinely minimally invasive procedure: Procedure outline. Comparison of the advantages, disadvantages, and outcomes of different surgical techniques of treating organ-confined prostate cancer (PCa). A literature review with special focus on perineal prostatectomy

“…Belt prepared a subsphincteric modification and Hudson a transsphincteric one. Dillon, Weldon, and Tavel also made further improvements [5, 6, 7]. …”