Comparison of the advantages of radical perineal prostatectomy and radicalretropubic prostatectomy

Introduction: Many urologists have been preferring radical retropubic prost atectomy (RRP) to radical perineal prostatectomy in order to facilitate pel vic lymphadenectomy. Recent studies concerning preoperative PSA and Gleason score with regard to negative lymphatic node status have given surgeons an opportunity to select those cases where lymphadenectomy can be avoided. Th is has revived interest in the perineal approach. We compared the perineal with the retropubic approach in radical prostatectomies performed by an uro logist. Method: Radical prostatectomy was performed either perineally or retropubic ally in a total of 138 patients. Results were grouped according to the foll owing parameters: estimated blood loss (EBL), frequency of blood transfusio ns, positive status of wound edges, complications, time required for surger y, requires quantity of analgesics, duration of hospital stay and "quality of life". Results: 79 patients (average age 64, [62a]) were subjected to RPP, whereas 59 patients (average age 61, [70a]) underwent RRP. There were no differenc es in respect of time require for surgery, positive status of wound edges o r complications, Average blood loss was 415 mi in the RPP group, whereas it was 1138 ml in the RRP group. Hospital stay of RPP group patients was 2.2 days shorter than with RRP group patients. Postoperative days until normal diet were 2.8 days less with the RPP group than with the RRP group. Oral an algesics could be administered to RPP group patients after 1.67 days and to RRP group patients after 3.75 days. After one year, 85% of the patients in both groups were no longer in need of pads,The overall "Quality of life" w as comparable. Conclusions: Perineal prostatectomy yields results that are comparable with those obtained with retropubic prostatectomy. The advantages of RPP includ e minimal blood loos, less need for postoperative care, lower consumption o f analgesics and a shorter hospitalisation time.