Practical considerations in radical retropubic prostatectoray

The key to achieving excellent outcomes following radical prostatectomy requires the selection of appropriate candidates for surgical intervention; development of an aggressive and proactive preoperative strategy to minimize complications; performing the surgical procedure quickly and methodically with good hemostasis and preservation of the rhabdosphincter and, when appropriate, the neurovascular bundle; compulsive immediate postoperative management; and a game plan to manage and postoperatively restore continence and potency. For men with a biologically significant cancer and 10-year life expectancy radical prostatectomy represents the optimal management based on cure, morbidity, and quality of life. This article presents practical tips gleaned from over 2,000 radical prostatectomies that the author has performed over the last 15 years.