[Radical prostatectomy in prostate cancer: indications and surgical approaches]

Prostate cancer is the most frequent in men: 71000 new cases were diagnosed in France in 2011. Early diagnosis allows treatments with curative intent. Risk groups by D'Amico classification system were validated to estimate progression risk after radical prostatectomy, external beam radiotherapy and brachytherapy. Radical prostatectomy is one of the reference treatments for localized prostate cancer. There are many surgical approaches: open retropubic approach, perineal, trans peritoneal or extra peritoneal laparoscopic approach, robotic assisted or not. Main surgical steps are the same between retropubic or laparoscopic approaches. Regarding oncologic (positive surgical margins rate, progression free survival) and functional results (continence and erections), no difference was reported between different surgical approaches.