[Total prostatectomy for cancer. Mortality and morbidity. Apropos of 1288 operations. The ANFUC survey]

A retrospective survey of total prostatectomies performed for cancer was conducted by 30 urologists members of the French Association of Continuing Education (ANFUC). This survey was limited to the operation itself and perioperative complications observed during hospitalization. Urinary sequellae including incontinence and impotency were excluded and reported elsewhere. The follow-up has been considered insufficient to evaluate the effect of total prostatectomy on the cancer. Post-operative mortality was 1%, in agreement with previously reported series. Complications were analyzed in two categories, general and local. General complications were observed in 9.3% of the patients. The most frequent local complications was haemorrhage (14.7%) and lymphocele or lymphatic fistulas (8.5%). There were 28 perforations of the rectum (2.17%) which were treated with simple suture (n = 21) or rectal suture with an upstream stomy (n = 5). Local urinary complications were fistulas of the urethro-bladder anastomosis (n = 25) and narrowing of the anastomosis (n = 5). There were also 4 urethral strictures and 2 complete sections of the urethra which were recognized and repaired immediately. This first analysis of early complications of total prostatectomy shows that this operation involves only acceptable risks in terms of mortality and morbidity. Over the last few years, total prostatectomy has become a routine operation in urology.