Case Series of Open Retropubic Radical Prostatectomy (RRP): Is this Old-fashioned Way Surgery for Prostate Cancer still Alive?

Abstract

Introduction: There are increasing number of advanced technology instruments to do prostatectomy in prostate cancer patient, such as Davinci Robot, Advanced laparoscopic instruments (e.g. bipolar vascular sealant, special knotting instruments). The cost of surgery and the availability of these advanced instruments and also surgeon skill are importance factors. RRP is the old open surgery technique for prostate cancer removal that has been blamed for its ineffectiveness about more bleeding, more operative time and longer hospital stay. But anyway, RRP may be a suitable  treatment for some rural hospitals  which has no advanced instruments or unaffordable patients.

Objective: To evaluate oncological outcome and functional outcome of open radical retropubic prostatectomy performed by a single surgeon’s experience

Material and Methods: 12 patients with localized prostate cancer who underwent Retropubic Radical Prostatectomy were enrolled. Oncological and functional outcomes were evaluated.

Results: Most of the patients (9 out of 12 cases) have no PSA progression and need no further treatment. There was one case of positive surgical margin in all of 12 cases. He refused Radiation so he has received hormonal treatment Another 2 of them had PSA progression, The first case underwent Intensity Modulated Radiation Therapy and 2 years course of hormonal treatment then stopped and he still has no PSA progression. The second patient, He had initial PSA at 58 ng/mL and Gleason’s score at 4+5, has been being received hormonal treatment alone after the PSA nadir did not drop to the level of lower 0.4 ng/mL. All of patients were pad free or had good urinary continence at 1 month after surgery. 7 out of 8 who had active sexual life before surgery, still have good sexual function at 9 months after surgery

Conclusion: Retropubic Radical Prostatectomy may still be an alternative choice of radical prostatectomy for early stage prostate cancer patient with acceptable oncological outcome and good quality of life.