Open radical prostatectomy

Abstract

Open retropubic radical prostatectomy (RRP) remains the “gold standard” treatment for clinically localised prostate cancer (PCa), while in recent years, other surgical treatment options such as laparoscopic and robot-assisted radical prostatectomy have become available at many centres worldwide. The three goals of treatment of localised PCa, in order of importance, are cancer control, preservation of urinary control and preservation of sexual function. Surgical expertise has reduced the complication rates of RP, decreased positive surgical margin rates and improved cancer control and functional results. In this chapter, we review the indications for and our institutional experience with RRP. We provide a description of the surgical technique and overview of the pre-and post-operative measures, surgery-related complications and surgical modifications to the standard operation to improve early return of urinary continence and erectile function. In addition, we review the oncological and functional results of RRP based on the available literature.