Pfannenstiel short horizontal laparotomy in retropubic radical prostatectomy

Objective: To evaluate the feasibility of the Pfannenstiel short horizontal laparotomy to perform retropubic radical prostatectomy and its consequence s on postoperative analgesic consumption. Materials and Methods: From December 1998 to February 2000, 62 radical pros tatectomies were performed via a short horizontal suprapubic incision. The mean length of the incision in the lower abdominal fold was 10.2 cm (range: 8 to 14 cm). The mean duration of radical prostatectomy was 130 minutes (r ange: 90 to 120 min). Double drainage (retropubic and subaponeurotic) was s ystemically maintained for an average of 48 hours. Postoperative narcotic a nalgesic consumption, and the modalities and duration of prescription were compared between 30 patients operated by this technique and 30 patients pre viously operated via a midline infraumbilical incision. Results: The abdominal wall opening and closing time was about 20 minutes. The operation was always performed via this incision, allowing excellent ex posure of lymph node areas and the prostate. Postoperative complications re lated to this incision consisted of a single subaponeurotic haematoma, whic h was not drained. The mean dosage and duration of postoperative analgesic consumption decreased by 44% compared to the reference group. Postoperative assessment of the abdominal wall showed almost complete disappearance of t he scar at 3 months and no secondary wound dehiscence. Conclusion: The Pfannenstiel short horizontal laparotomy is a simple and re producible technique for retropubic radical prostatectomy. This feasibility study was accompanied by a reduction of postoperative analgesic consumptio n in the study group.