Jan. 01, 2009 -- Question: How successful is a radical laparoscopic, perineal or retropubic prostatectomy?
Answer: There are at least three or four different ways to perform prostatectomy. One is through an incision made underneath the scrotum, that's called a perineal prostatectomy. The other is through an incision made through the lower abdomen, that's called a retropubic prostatectomy. And, of course, as has been mentioned on other questions, the laparoscopic and/or the robotic prostatectomy. The successes for each of these very much depends on your personal history, the type of prostate cancer you have, and what your expectations are. Clearly, the most important thing to most patients is that they become cancer-free. And the results of becoming cancer-free with any of these techniques very much depends on your pathology -- how much cancer you have, what your PSA is, what your Gleason score is, what the margins look like after the prostate's been removed, if the lymph nodes are involved. These are all very important questions when determining your cancer outcome or your cancer benefit from the surgery.
The other types of things you might want to consider in the long term are continence and potency. All forms of prostatectomy have been shown to have roughly equivalent continence rates. The only difference is those who undergo robotic or laparoscopic prostatectomy seem to regain their continence a little bit faster than those who undergo open or retropubic or perineal prostatectomy. These are very complicated decisions that you need to discuss with your doctor, but asking the right questions is key.