Clinical comparative evaluation of radical retropubic and perineal prostatectomy approaches for prostate cancer

We compared the outcomes, advantages, and disadvantages of retropubic and perineal approaches to radical prostatectomy for prostate cancer. From 1990 to 2000, 37 patients (average age: 66.6 years) who underwent radical retropubic prostatectomy (RRP) and 30 patients (average age: 70.1 years) who underwent radical perineal prostatectomy (RPP) were identified from the database of our department. Outcome measures included operative duration, estimated blood loss, blood transfusions, positive margins, complications, and incontinence rates. There were no differences between the RRP and RPP groups in complications, incontinence rates, or positive margins. The mean operative duration was 228 min in the RRP group and 198 mm in the RPP group (p < 0.05). The mean estimated blood loss was 1,060 ml in the RRP group and 717 ml in the RPP group (p < 0.01). The mean volume of blood transfusions was 620 ml in 17 patients in the RPP group and 700 ml in one patient in the RPP group (p < 0.001). In conclusion, the clinical results of RRP and RPP groups were similar; the advantages of the perineal approach were shorter operative duration, smaller estimated blood loss and less blood transfusion.