A comparison of the relative merits of radical perineal and radical retropubic prostatectomy

Objective To compare the outcome, advantages and disadvantages of retropubi c and perineal approach to radical prostatectomy, as performed by one surge on. Patients and methods This unrandomized study included 138 patients who unde rwent either radical retropubic (RRP) or radical perineal prostatectomy (RP P), based on the specific conditions or the patient's choice; 79 patients ( mean age 64.6 years) underwent RPP and 59 (mean age 61.7 years) RRP. Outcom e measures included estimated blood loss, the incidence of blood transfusio ns, positive margins and complications, operative duration, analgesic use, days in hospital and quality of life. Results There was no difference in operative duration, and the incidence of positive margins or complications between the groups. The mean estimated b lood loss in the RPP and RRP groups was 415 and 1138 mt, respectively. The RPP group stayed a mean of 2.2 days less in hospital and took 2.8 days less to regain a full diet than the RRP group; the RPP group needed 1.7 days be fore using oral analgesics and the RRP group 3.8 days. Of patients in both groups, 85% were pad-free at one year and their overall quality of life was similar. Conclusions The results of RRP and RPP are comparable; the advantages of th e perineal approach include minimal blood loss, low-intensity postoperative nursing care, low analgesic use and earlier discharge from hospital.