Early Complications of Contemporary Anatomical Radical Retropubic Prostatectomy

Anatomical radical retropubic prostatectomy is commonly performed to treat select patients with clinically localized prostate cancer. Because this recently introduced surgical technique is technically demanding, and since early detection programs have altered the age and stage distribution of men undergoing radical prostatectomy, earlier reports describing complication and death rates from radical prostatectomy may not accurately reflect contemporary experience. A retrospective review of 1,342 radical retropubic prostatectomies performed during a 5-year period showed an early complication rate of 7.4%. The most common complications were thromboembolic (pulmonary embolism) and cardiac (myocardial infarction). Patient age, mode of diagnosis (transurethral resection of the prostate versus needle biopsy) and pathological stage of the tumor did not correlate with the rate of complications. Three patients died in this series (0.2%). This retrospective review shows that contemporary anatomical retropubic radical prostatectomy may be performed with acceptably low early morbidity and mortality rates, and that appropriate selection of chronologically older patients is not associated with significantly greater rates of early complications. These data may be useful in decision analytic models evaluating the role of therapy for patients with early stage prostate cancer.