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Open Radical Retropubic Prostatectomy

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Radical Prostatectomy

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Abstract

Radical prostatectomy (RP) is the mainstay of treatment for patients with clinically localized prostate cancer, especially for those patients with high-risk cancer. Large multi-institutional studies have documented excellent long-term outcomes in terms of biochemical recurrence rates and prostate cancer-specific mortality after RP. Proper preoperative planning begins with selecting patients who have potentially lethal cancers and are likely to benefit from surgery, and in whom RP is reasonably likely to remove the entire tumor. Magnetic resonance imaging (MRI) is used to delineate the anatomic details of the prostate and of the cancer, and can assist in customizing the operation, particularly in regard to nerve sparing. Oncologic and functional outcomes are highly dependent on surgical technique and on the surgeon’s level of experience. In our experience, early release of the neurovascular bundles, full preservation of urethral length, complete excision of the seminal vesicles, and wide dissection with careful reconstruction of the bladder neck are key components to optimal cancer control and recovery of sexual and urinary function. In this chapter, we provide a detailed description of our approach to retropubic RP.

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Abbreviations

RP:

Radical prostatectomy

PSA:

Prostate-specific antigen

DRE:

Digital rectal examination

PLND:

Pelvic lymph node dissection

NVB:

Neurovascular bundle

BCR:

Biochemical recurrence

PCSM:

Prostate cancer specific mortality

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Author information

Authors and Affiliations

  1. Southern California Permanente Medical Group, Fontana, CA, USA

    Stephen A. Poon M.D.

  2. Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Peter T. Scardino M.D.

Authors
  1. Stephen A. Poon M.D.
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  2. Peter T. Scardino M.D.
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Corresponding author

Correspondence to Peter T. Scardino M.D. .

Editor information

Editors and Affiliations

  1. Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    James A. Eastham

  2. Brady Urological Institute, Johns Hopkins Medical Institution, Baltimore, Maryland, USA

    Edward M. Schaeffer

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Poon, S.A., Scardino, P.T. (2014). Open Radical Retropubic Prostatectomy. In: Eastham, J., Schaeffer, E. (eds) Radical Prostatectomy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8693-0_7

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  • DOI: https://doi.org/10.1007/978-1-4614-8693-0_7

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