[Surgical treatment of prostate cancer]

Surgical treatment of prostatic carcinoma is used at the two extremities of the course of the disease. In the initial stage when the tumour is confined to the prostate, radical prostatectomy entails the best prognosis for cure by removal of the tumour, at the cost of slight morbidity, particularly the risk of subsequent impotence. However, the volume of the tumour often is greatly underestimated and the surgical excision does not reach healthy tissue in almost one out of two cases; in this case, it cannot be considered fully curative. Surgery has an important role in the metastatic phase, either as hormonal treatment (surgical castration) or with the aim of re-establishing urine flux (transurethral prostatic resection or urine derivation).