Postsurgical Management of the Patient Undergoing Radical Prostatectomy

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Abstract
Summary— Radical prostatectomy is a useful procedure for the treatment of prostate cancer limited to the gland; however, failure may occur as a result of the immediate or delayed complications of surgery, or to disease recurrence related to incomplete tumour excision. Seventy‐nine radical prostatectomies were performed between April 1985 and August 1991 in patients with prostate cancer (primarily stage B1) who averaged 63 years of age. Immediate post‐operative complications included vesicocutaneous fistulae, cystic lymphangiomas, abdominal wall abscesses, extraperitoneal haematoma, acute cholecystitis, and enterocutaneous fistula. Massive pulmonary embolism accounted for 2 deaths. Of the 77 surviving patients followed up for an average of 34 months, 79.2% (61) were continent, 15.6% had stress‐related incontinence or severe incontinence and 5.2% were lost to follow‐up. Sexual potency was preserved in 13 of the 33 patients (39%) who were pre‐operatively potent. A favourable outcome as defined by no recurrence was seen in 69 patients (87.3%). Four patients (5.1%) are living with recurring prostatic cancer and 1 patient has died of the disease 46 months after surgery.