Radical Perineal Prostatectomy

Abstract

Radical perineal prostatectomy remains as relevant today as when it was first described more than a century ago. Despite the increasing popularity of laparoscopic and robotic surgery, not every patient qualifies for these approaches, and these patients should not be denied the option of surgical treatment based on contraindications to a single surgical approach. In these patients the perineal approach is an excellent alternative, offering ease of access, good visualization, low blood loss, ability to preserve the neuro-vascular bundles and potency, early post operative mobilization and short hospital stay, particularly to patients with low and intermediate risk disease, providing cure rates comparable with any other approach while keeping salvage options open should they be required at a later stage. This procedure is also especially relevant in developing countries, where access to first world technology and intensive care facilities in the post-op period may be limited which these patients seldom require due to the low morbidity of the surgery.