Radical Prostatectomy

Abstract

Radical prostatectomy is the oldest continuously employed treatment for prostate cancer. The technique of radical perineal prostatectomy was developed by Hugh Hampton Young at The Johns Hopkins Hospital in 1904. Since that time a variety of therapeutic alternatives have become available: transurethral resection for the relief of bladder outlet obstruction, hormonal therapy and radiation therapy. With the development of these therapeutic alternatives and with a greater understanding of the limitations of radical surgery in the cure of prostatic cancer, it has become necessary on many occasions to redefine the criteria for the selection of surgical candidates. Simply stated, to cure carcinoma of the prostate with surgery the tumour must be confined to the prostate and all tumour must be removed. In the past, few patients were felt to be candidates for surgery because most men presented with advanced stages of the disease and the side effects of surgery were felt by many to be worse than the disease.