Radical perineal vs. retropubic prostatectomy: a review of optimal application and technical considerations in the utilization of these exposures.

Abstract

Radical prostatectomy can be performed either with a retropubic or perineal approach. While the former has enjoyed popularity in recent years, perineal prostatectomy has undergone a substantial resurgence because of interest in laparoscopic pelvic lymphadenectomy. The advantages and disadvantages of each are defined, as well as technical modifications that have been developed seeking to diminish problems with each approach. While many urologic surgeons are no longer familiar with the perineal approach, its potential advantages, particularly in certain situations, would suggest that it can be a valuable component of the uro-oncologist's surgical armamentarium for the management of localized prostate cancer.