Radical perineal prostatectomy versus radical retropubic prostatectomy after previous prostate surgery: surgical and functional outcomes

Abstract

Purpose: We performed a retrospective review of our database to evaluate surgical and functional outcomes in men undergoing radical perineal prostatectomy (RPP) versus radical retropubic prostatectomy (RRP) after previous prostate surgery.

Patients and methods: A total of 616 men underwent RPP at our institution. A retrospective review of these patients showed that 59 had a history of previous surgical approach for benign prostatic hyperplasia. A second group of 59 match-paired prostate cancer patients with a history of previous prostate surgery, treated by RRP, were recruited in the our database and was used as control group. All patients were followed up at 3, 6 and 12 months and evaluated during an office evaluation with regard to urinary incontinence and erectile dysfunction.

Results: Overall complete continence was achieved in 49 (83%), 51 (86.4%) and 55 (93.2%) RPP patients at 3, 6 and 12 months, respectively, versus 39 (66.1%), 42 (71.1%) and 47 (79.6%) RRP patients, respectively (p = 0.03, p = 0.04 and p = 0.03, respectively). No significant difference was reported between the two groups in the overall percentage of preserved normal erectile function.

Conclusions: Radical prostatectomy in patients with previous prostate surgery should be performed with the transperineal rather than the retropubic approach.