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Organo Oficial de la Sociedad Mexicana de Urología

2010, Number 4

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Rev Mex Urol 2010; 70 (4)

Radical retropubic prostatectomy in localized prostate cancer treatment: experience at the Centro Médico of the Instituto de Seguridad Social in the State of Mexico

Costilla-Montero A, Guadarrama-Benítez B, Aragón-Castro MA, Gutiérrez-Rosales R, González-Ruíz F, Palma-Mercado J, Cisneros-Chávez R, Carrillo-Ponce C, Morales-Padilla CA, Martínez-Martínez MA

Language: Spanish
References: 27
Page: 199-205
PDF size: 3939.83 Kb.


ABSTRACT

Introduction: Radical retropubic prostatectomy is a therapeutic process that has been shown to be of much benefit in the management of organ-confined prostate cancer patients.
Objective: To present retropubic radical prostatectomy experience in organ-confined prostate cancer patients at the authors’ hospital department.
Methods: The case records of 82 patients having undergone this surgical procedure during the time frame of November 2004 to July 2009 in the authors’ hospital department were reviewed. Of that total, 78 were eligible for the study. The variables of age, genetic load for prostate cancer, history of smoking, clinical stage, pathology stage, Gleason score, preoperative and postoperative prostate specific antigen, surgery duration, anesthesia duration, histopathological report, and complications were evaluated for all patients.
Results: Mean age of patients was 63.7 years with a 49-78 year range. Mean preoperative prostate specific antigen value was 9.2 ng/mL, with a 4.3-21.2 ng/mL range, and postoperative prostate specific antigen value was 0.2 ng/mL, with a 0.003- 1.2 ng/mL range. Preoperative Gleason score values from transrectal prostate biopsies were analyzed and well-differentiated tumor was found in 5 patients (6.4%), moderately differentiated tumor in 70 patients (89.7%) and poorly differentiated tumor in 3 patients (3.84%). Histopathological analysis revealed 67 patients (85.8%) with organ-confined tumor and 7 patients (8.9%) with periprostatic infiltration data (4 with capsular infiltration and 3 with seminal vesicle invasion). In 4 patients (5.12%) final histopathological report was negative for tumor disease despite the fact that previous biopsy report had been positive for adenocarcinoma. Mean surgical duration was 104.51 minutes. Complications presenting at 3 months after surgery were: urethral stricture in 13 patients (16.6%), erectile dysfunction in 45 patients (58%) and urinary incontinence in 13 patients (16.6%). Complications presenting at one year after surgery were: erectile dysfunction in 16 patients (33%) and persistent urinary incontinence in 2 patients (3.2%). Of the 78 patients included in the study, no deaths secondary to prostate adenocarcinoma were registered. Maximum follow-up time was 55 months.
Conclusions: Radical retropubic prostatectomy was shown to be a useful procedure with very good results for treatment of organ-confined prostate cancer in the population studied.


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