Evaluation of complications and results in a contemporary series of 300 consecutive radical retropubic prostatectomies with the anatomic approach at a single institution.

摘要

OBJECTIVES: To evaluate the complications and results of radical retropubic prostatectomy with the anatomic approach, at our center, to allow a comparison with published studies and precise patient counseling. METHODS: We reviewed the charts and records of the follow-up visits of all patients who consecutively underwent radical retropubic prostatectomy for clinically intracapsular prostate cancer between March 1997 and February 2002. RESULTS: The pathologic stage was pT0 in 4 patients (1.3%), pT2a in 83 (27.7%), pT2b in 116 (38.7%), pT3a in 52 (17.3%), pT3b in 38 (12.6%), and pT4 in the remaining 7 (2.4%). Extracapsular disease extension was present in 97 specimens (32.3%); it was associated with positive margins in 64 patients (21.3%). Intraoperative and postoperative complications were recorded in 19 patients (6.3%). Immediate surgical repair was necessary in 3 cases (1%) and delayed in 5 (1.7%). A stricture of the vesicourethral anastomosis was observed in 2 patients (0.7%). At a median follow-up of29 months (range 6 to 57), a total of 262 patients (88.8%) was continent; 26 patients (8.8%) had stress incontinence, and 7 were incontinent (2.3%). Of 262 patients, 128 (48.2%) achieved continence within the first day of catheter removal. CONCLUSIONS: Radical retropubic prostatectomy is associated with low complication rates; with the anatomic approach, a limited incidence of incontinence is attainable, consistent with major referral centers.