Radical prostatectomy: Making it a better operation in the new millennium

Radical prostatectomy provides the best hope for long-term survival, free o f disease, for organ-confined adenocarcinoma of the prostate. The operation is performed successfully only by understanding the remarkable anatomic va riability of the prostate apex and the cylindrical nature of the striated u rethral sphincter. When surgical techniques are used that take into account variations at the apex, with preservation of (i) neurovascular structures; (ii) the sphincteric urethra; and (iii) the adjacent levator ani, patients can look forward to a cure and the rapid return of urinary control and ere ctile function.