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Radical perineal prostatectomy - the contemporary resurgence of a genuinely minimally invasive procedure: Procedure outline. Comparison of the advantages, disadvantages, and outcomes of different surgical techniques of treating organ-confined prostate cancer (PCa). A literature review with special focus on perineal prostatectomy.

Wroński S - Cent European J Urol (2012)

Bottom Line: This manuscript presents the technique of RPP used in the author's institution.RPP proves to be a very efficacious, cost-effective treatment option for localized PCa.The outcomes of RPP, as defined by continence, potency, and complication rate, are equivalent to those accomplished by other methods.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, J. Biziel Memorial University Hospital, Bydgoszcz, Poland.

ABSTRACT

Introduction: Surgery plays a central role in the management of organ-confined prostate cancer (PCa). Four types of prostatectomy are currently practiced: perineal, retropubic, laparoscopic, and robot-assisted. The qualification criteria for all types are similar. Radical perineal prostatectomy (RPP) was the first method introduced into clinical practice, however, it has been neglected in favor of other procedures. Its resurgence has been facilitated by a multitude of advantages. Unfortunately, nowadays most urologists are not familiar with the perineal approach though many centers have begun to implement it.

Materials and methods: This manuscript presents the technique of RPP used in the author's institution. It also reviews a vast body of literature on the four techniques of prostatectomy including their advantages and outcomes. The data was collected from the literature and medical databases.

Conclusion: RPP proves to be a very efficacious, cost-effective treatment option for localized PCa. The outcomes of RPP, as defined by continence, potency, and complication rate, are equivalent to those accomplished by other methods.

No MeSH data available.


Related in: MedlinePlus

The prostate coated with white posterior layer of the Denonvillier's fascia is visible at the center of the wound.
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Figure 0002: The prostate coated with white posterior layer of the Denonvillier's fascia is visible at the center of the wound.

Mentions: First the patient is placed in the lithotomy position with highly elevated pelvis and hips rotated outwards. The incision runs around the anal rim. Subcutaneous fascia and fat tissue are cut away and divided. The operator's finger crosses over the central tendon securing the anal sphincter. The tendon is transected and the ischiorectal fossa is created bluntly with the fingers. The anal levators are retracted laterally and recto-urethralis muscle extending from urethra to the rectum is dissected (Fig. 1). The rectum is mobilized and retracted downward. A curved Lowsley retractor placed into the bladder brings the prostate to the perineal plane. The white posterior layer of Denonvillier's fascia became visible (Fig. 2). The final target of the procedure is suitably exposed.


Radical perineal prostatectomy - the contemporary resurgence of a genuinely minimally invasive procedure: Procedure outline. Comparison of the advantages, disadvantages, and outcomes of different surgical techniques of treating organ-confined prostate cancer (PCa). A literature review with special focus on perineal prostatectomy.

Wroński S - Cent European J Urol (2012)

The prostate coated with white posterior layer of the Denonvillier's fascia is visible at the center of the wound.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921814&req=5

Figure 0002: The prostate coated with white posterior layer of the Denonvillier's fascia is visible at the center of the wound.
Mentions: First the patient is placed in the lithotomy position with highly elevated pelvis and hips rotated outwards. The incision runs around the anal rim. Subcutaneous fascia and fat tissue are cut away and divided. The operator's finger crosses over the central tendon securing the anal sphincter. The tendon is transected and the ischiorectal fossa is created bluntly with the fingers. The anal levators are retracted laterally and recto-urethralis muscle extending from urethra to the rectum is dissected (Fig. 1). The rectum is mobilized and retracted downward. A curved Lowsley retractor placed into the bladder brings the prostate to the perineal plane. The white posterior layer of Denonvillier's fascia became visible (Fig. 2). The final target of the procedure is suitably exposed.

Bottom Line: This manuscript presents the technique of RPP used in the author's institution.RPP proves to be a very efficacious, cost-effective treatment option for localized PCa.The outcomes of RPP, as defined by continence, potency, and complication rate, are equivalent to those accomplished by other methods.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, J. Biziel Memorial University Hospital, Bydgoszcz, Poland.

ABSTRACT

Introduction: Surgery plays a central role in the management of organ-confined prostate cancer (PCa). Four types of prostatectomy are currently practiced: perineal, retropubic, laparoscopic, and robot-assisted. The qualification criteria for all types are similar. Radical perineal prostatectomy (RPP) was the first method introduced into clinical practice, however, it has been neglected in favor of other procedures. Its resurgence has been facilitated by a multitude of advantages. Unfortunately, nowadays most urologists are not familiar with the perineal approach though many centers have begun to implement it.

Materials and methods: This manuscript presents the technique of RPP used in the author's institution. It also reviews a vast body of literature on the four techniques of prostatectomy including their advantages and outcomes. The data was collected from the literature and medical databases.

Conclusion: RPP proves to be a very efficacious, cost-effective treatment option for localized PCa. The outcomes of RPP, as defined by continence, potency, and complication rate, are equivalent to those accomplished by other methods.

No MeSH data available.


Related in: MedlinePlus