The Role of Radical Prostatectomy in the Treatment of Cancer of the Prostate

  • Herbert Lepor
Part of the Cancer Treatment and Research book series (CTAR, volume 46)


Radical perineal prostatectomy was originally described by Kuchler in Germany in 1866 [1]. Hugh Hampton Young modified the perineal approach to radical prostatectomy by making the operation more anatomical and practical [2]. Young’s original technique was associated with urinary-incontinence in approximately 50% of cases [3]. The surgical approach to radical prostatectomy has undergone many additional modifications and refinements. Vest described a technique for approximating the bladder to the urethra so that tension would be taken off the external sphincter [4]. The anastamosis was performed using mattress sutures placed anteriorly and laterally. Jewett further modified the anastamosis by substituting simple sutures for Vest’s mattress sutures and by providing a mattress suture that approximated the anterolateral bladder wall to the urethra [4]. The water tight anastomosis of the bladder and urethra decreased the incidence of incontinence and anastomotic strictures.


Prostate Cancer Radical Prostatectomy Bladder Outlet Obstruction Radical Retropubic Prostatectomy Johns Hopkins Hospital 
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© Kluwer Academic Publishers, Boston 1989

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  • Herbert Lepor

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