[Pfannenstiel short horizontal laparotomy in retropubic radical prostatectomy]

To evaluate the feasibility of the Pfannenstiel short horizontal laparotomy to perform retropubic radical prostatectomy and its consequences on postoperative analgesic consumption.

From December 1998 to February 2000, 62 radical prostatectomies were performed via a short horizontal suprapubic incision. The mean length of the incision in the lower abdominal fold was 10.2 cm (range: 8 to 14 cm). The mean duration of radical prostatectomy was 130 minutes (range: 90 to 210 min). Double drainage (retropubic and subaponeurotic) was systematically maintained for an average of 48 hours. Postoperative narcotic analgesic consumption, and the modalities and duration of prescription were compared between 30 patients operated by this technique and 30 patients previously operated via a midline infraumbilical incision.

The abdominal wall opening and closing time was about 20 minutes. The operation was always performed via this incision, allowing excellent exposure of lymph node areas and the prostate. Postoperative complications related to this incision consisted of a single subaponeurotic haematoma, which was not drained. The mean dosage and duration of postoperative analgesic consumption decreased by 44% compared to the reference group. Postoperative assessment of the abdominal wall showed almost complete disappearance of the scar at 3 months and no secondary wound dehiscence.

The Pfannenstiel short horizontal laparotomy is a simple and reproducible technique for retropubic radical prostatectomy. This feasibility study was accompanied by a reduction of postoperative analgesic consumption in the study group.