Critical surgical techniques for radical perineal prostatectomy

Arnold Melman, Judd Boczko, Johanna Figueroa, Albert C. Leung

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: Radical perineal prostatectomy was historically the surgical treatment of choice for localized adenocarcinoma of the prostate until the 1980s when radical retropubic prostatectomy began to gain popularity. Nevertheless, the perineal approach possesses advantages that prompt resurgence in the interest of this classic operation. We review the relevant anatomy and our modified technique of performing a successful radical perineal prostatectomy. Materials and Methods: The English literature pertaining to the different surgical approaches to radical perineal prostatectomy was reviewed through PubMed. Attention was paid to its indications, anatomical significance and various surgical techniques. Results: Studies demonstrate no difference in the incidence of positive surgical margins and biochemical recurrence between radical retropubic and perineal prostatectomies. Furthermore, the perineal approach avoids the dorsal venous complex and better facilitates the vesicourethral anastomosis in the face of minimal pain and requirement for transfusion. We use a modified Belt approach, aiming to yield the most optimal outcome with minimal morbidity. A meticulous anatomical approach is warranted if complications such as rectal injury, incontinence and erectile dysfunction are to be minimized. Conclusions: With careful preoperative evaluation, selected patients should benefit from radical perineal prostatectomy for the management of localized prostate cancer. Familiarity with this specialized technique should be an immeasurable addition to any armamentarium in the therapy of prostatic diseases.

Original languageEnglish (US)
Pages (from-to)786-790
Number of pages5
JournalJournal of Urology
Volume171
Issue number2 I
DOIs
StatePublished - Feb 2004

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Prostatectomy
Prostatic Diseases
Literature
Facial Pain
Erectile Dysfunction
PubMed
Prostate
Prostatic Neoplasms
Anatomy
Adenocarcinoma
Morbidity
Recurrence
Incidence
Wounds and Injuries
Therapeutics

Keywords

  • Prostatectomy
  • Prostatic neoplasm

ASJC Scopus subject areas

  • Urology

Cite this

Critical surgical techniques for radical perineal prostatectomy. / Melman, Arnold; Boczko, Judd; Figueroa, Johanna; Leung, Albert C.

In: Journal of Urology, Vol. 171, No. 2 I, 02.2004, p. 786-790.

Research output: Contribution to journalArticle

Melman, A, Boczko, J, Figueroa, J & Leung, AC 2004, 'Critical surgical techniques for radical perineal prostatectomy', Journal of Urology, vol. 171, no. 2 I, pp. 786-790. https://doi.org/10.1097/01.ju.0000107834.23316.59
Melman, Arnold ; Boczko, Judd ; Figueroa, Johanna ; Leung, Albert C. / Critical surgical techniques for radical perineal prostatectomy. In: Journal of Urology. 2004 ; Vol. 171, No. 2 I. pp. 786-790.
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