Radical Prostatectomy After Previous Prostatic Surgery

It has been demonstrated that Young's radical perineal prostatectomy, which involves removal of the prostate and the seminal vesicles, is the treatment of choice for early cancer of the prostate gland.1Occult or unsuspected carcinoma of the prostate discovered accidentally after biopsy or conservative prostatectomy by any route is usually early. It probably occurs in at least 9% to 10% of men over 50 years of age2and is thus a real problem. Hinman and Hinman, in discussing the justification for radical prostatectomy after previous operative discovery of unsuspected prostatic carcinoma, concluded, "... radical perineal prostatectomy seems indicated if an apparently localized area of carcinoma is found either on transurethral resection or on open prostatectomy."3Nesbit and Baum have recently questioned the above statement in the light of present availablesurvival statistics with conservative therapy.4 The present study concerns 23 cases of radical prostatectomy after previous prostatic surgery