Long-term results of radical retropubic prostatectomy

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Abstract

The results of a survey of the patients with a prostatic carcinoma, who have undergone a retropubic prostatectomy and a medical supervision within a maximum period of 9 years, are presented. The data about 94 patients with a prostatic carcinoma, who have undergone a retropubic prostatectomy and a pelvic lymphadenectomy in the time period since 2005 till 2013 in the Urology Department of SBO RR “RCH”, are retrospectively estimated. An average age of the patients was 63,5+7,8 years, a median of prostatic specific antigen is 11,6 ng/ml. Possessing the median of supervision as 44 months a biochemical recurrence is revealed in a total of 18 patients (19,1%) with the avarage time before its development 13 months. 5-years cancrispecific survival rate in D’Amico risk group terms in the postoperative period estimated as: 1) low - 100%, 2) intermediate - 94,4%, 3) high - 81,8% The most frequent delayed postoperative sequela were enuresis - 24,4% of the patients - within the period of 12 months after a retropubic prostatectomy performance, erectile dysfunction - 69,1% of the patients, stenoses of vesicourethral inosculation - 10,6% of the patients. Considering our data an erectile dysfunction after a retropubic prostatectomy performance occurred in 1,2 times more frequent after a retropubic prostatectomy performance without nerve tracts preservation. In the group of patients who have undergone a retropubic prostatectomy with a neck of urinary bladder, proximal and distal ends of urethra preservation, 16 (94,1%) patients are able to keep urine completely, in the group of patients who have undergone a retropubic prostatectomy without a neck of urinary bladder, proximal and distal ends of urethra preservation 46 patients (71,9%) haven’t got urinary incontinence. A retropubic radical prostatectomy revealed good results of oncological effectiveness among the patients with a prostatic carcinoma in a low risk group as well as in intermediate and high risk groups. Thorough selection of the patients who can undergo a retropubic prostatectomy with nerve tracts preservation, with a neck of urinary bladder, proximal and distal parts of urethra preservation makes it possible to improve the functional results of sergical operations without a loss of oncological effectiveness.

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Copyright (c) 2015 Kaprin A.D., Kostin A.A., Filimonov V.B., Vasin R.V., Ivanova A.Y.

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