Surgical Treatment of Prostate Cancer

  • Mark R. Feneley
  • Roger S. Kirby


Surgery for prostate cancer has evolved, with the main purpose of curing one of the most common male malignancies at an early stage in its natural history, and preventing the morbidity otherwise associated with unchecked disease progression to more advanced, incurable stages. The operation by which this may be achieved, radical prostatectomy, advanced considerably during the 20th century through developments in anatomical knowledge and surgical experience. It is now a routine surgical procedure in urological oncology carried out through a range of surgical approaches, each with its own advantages and disadvantages.


Prostate Cancer Radical Prostatectomy Erectile Function Localize Prostate Cancer Neurovascular Bundle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Young HH. The early diagnosis and radical cure of carcinoma of the prostate: being a study of 40 cases and presentation of a radical operation which was carried out in four cases. Johns Hopkins Hosp Bull 1905;16:315–321.Google Scholar
  2. 2.
    Young HH, Davis DM. Neoplasms of the urogenital tract. In: Young’s Practice of Urology. Philadelphia: WB Saunders, 1926;653–654.Google Scholar
  3. 3.
    Millin T. Retropubic prostatectomy: a new extravesical technique report on 20 cases. Lancet 1945;693–696.Google Scholar
  4. 4.
    Reiner WG, Walsh PC. An anatomical approach to the surgical management of the dorsal vein and Santorini’s plexus during radical retropubic surgery. J Urol 1979;121(2):198–200.PubMedGoogle Scholar
  5. 5.
    Walsh PC, Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982;128(3):492–497.PubMedGoogle Scholar
  6. 6.
    Walsh PC, Lepor H, Eggleston JC.Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate 1983;4(5):473–485.PubMedCrossRefGoogle Scholar
  7. 7.
    Lepor H, Gregerman M, Crosby R, Mostofi FK, Walsh PC. Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis. J Urol 1985;133:207–212.PubMedGoogle Scholar
  8. 8.
    Walsh PC.Anatomic radical prostatectomy: evolution of the surgical technique. J Urol 1998;160:2418–2424.Google Scholar
  9. 9.
    Walsh PC, Epstein JI, Lowe FC. Potency following radical prostatectomy with wide unilateral excision of the neurovascular bundle. J Urol 1987;138(4):823–827.PubMedGoogle Scholar
  10. 10.
    Schuessler WW, Kavoussi LR, Clayman RV, Vancaille TH. Laparoscopic radical prostatectomy: initial case report. J Urol 1992;147(4):246.Google Scholar
  11. 11.
    Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology 1997;50(6):854–857.PubMedCrossRefGoogle Scholar
  12. 12.
    Cadeddu JA, Kavoussi LR. Laparoscopic radical prostatectomy: is it feasible and reasonable? Urol Clin North Am 2001;28(3):655–661.PubMedCrossRefGoogle Scholar
  13. 13.
    Guillonneau B, Vallancien G. Laparoscopic radical prostatectomy: the Montsouris experience. J Urol 2000;163(2):418–422.PubMedCrossRefGoogle Scholar
  14. 14.
    Bollens R, Roumeguere T, Vanden Bossche M, Quackels T, Zlotta AR, Schulman CC. Comparison of laparoscopic radical prostatectomy techniques. Curr Urol Rep 2002;3(2):148–151.PubMedGoogle Scholar
  15. 15.
    Guillonneau B, Cappele O, Martinez JB, Navarra S, Vallancien G. Robotic assisted, laparoscopic pelvic lymph node dissection in humans. J Urol 2001;165(4):1078–1081.PubMedCrossRefGoogle Scholar
  16. 16.
    Abbou CC, Hoznek A, Salomon L, et al. Laparoscopic radical prostatectomy with a remote controlled robot. J Urol 2001;165(6 pt 1):1964–1966.PubMedGoogle Scholar
  17. 17.
    Prasad SM, Maniar HS, Soper NJ, Damiano RJJ, Klingensmith ME. The effect of robotic assistance on learning curves for basic laparoscopic skills. Am J Surg 2002;183(6):702–707.PubMedCrossRefGoogle Scholar
  18. 18.
    Stolzenburg JU, Truss MC. Technique of laparoscopic (endoscopic) radical prostatectomy. BJU Int 2003;91(8):749–757.PubMedCrossRefGoogle Scholar
  19. 19.
    Menon M. Robotic radical retropubic prostatectomy. BJU Int 2003;91(3):175–176.PubMedCrossRefGoogle Scholar
  20. 20.
    Han M, Partin AW, Pound CR, Epstein JI, Walsh PC. Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy. The 15-year Johns Hopkins experience. Urol Clin North Am 2001;28(3):555–565.PubMedCrossRefGoogle Scholar
  21. 21.
    Jewett HJ, Bridge RW, Gray GFJ, Shelley WM. The palpable nodule of prostatic cancer. Results 15 years after radical excision. JAMA 1968;203(6):403–406.PubMedCrossRefGoogle Scholar
  22. 22.
    Walsh PC. Radical prostatectomy, preservation of sexual function, cancer control. The controversy. Urol Clin North Am 1987;14(4):663–673.PubMedGoogle Scholar
  23. 23.
    Han M, Partin AW, Piantadosi S, Epstein JI, Walsh PC. Era specific biochemical recurrence-free survival following radical prostatectomy for clinically localized prostate cancer. J Urol 2001;166(2):416–419.PubMedCrossRefGoogle Scholar
  24. 24.
    Han M, Partin AW, Zahurak M, Piantadosi S, Epstein JI, Walsh PC. Biochemical (prostate specific antigen) recurrence probability following radical prostatectomy for clinically localized prostate cancer. J Urol 2003;169(2):517–523.PubMedCrossRefGoogle Scholar
  25. 25.
    Partin AW, Mangold LA, Lamm DM, Walsh PC, Epstein JI, Pearson JD. Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology 2001;58(6):843–848.PubMedCrossRefGoogle Scholar
  26. 26.
    Khan MA, Han M, Partin AW, Epstein JI, Walsh PC. Long-term cancer control of radical prostatectomy in men younger than 50 years of age: update 2003. Urology 2003;62(1):86–91.PubMedCrossRefGoogle Scholar
  27. 27.
    Carter HB, Epstein JI, Partin AW. Influence of age and prostate-specific antigen on the chance of curable prostate cancer among men with nonpalpable disease. Urology 1999;53(1):126–130.PubMedCrossRefGoogle Scholar
  28. 28.
    Pound CR, Partin AW, Eisenberger MA, Chan DW, Pearson JD, Walsh PC. Natural history of progression after PSA elevation following radical prostatectomy. JAMA 1999;281(17):1591–1597.PubMedCrossRefGoogle Scholar
  29. 29.
    Partin AW, Borland RN, Epstein JI, Brendler CB. Influence of wide excision of the neurovascular bundle(s) on prognosis in men with clinically localized prostate cancer with established capsular penetration. J Urol 1993;150(1):142–146.PubMedGoogle Scholar
  30. 30.
    Smith RC, Partin AW, Epstein JI, Brendler CB. Extended followup of the influence of wide excision of the neurovascular bundle(s) on prognosis in men with clinically localized prostate cancer and extensive capsular perforation. J Urol 1996;156(2 pt 1):454–457.PubMedGoogle Scholar
  31. 31.
    Shah O, Robbins DA, Melamed J, Lepor H. The New York University nerve sparing algorithm decreases the rate of positive surgical margins following radical retropubic prostatectomy. J Urol 2003;169(6):2147–2152.PubMedCrossRefGoogle Scholar
  32. 32.
    Walsh PC. Anatomic radical retropubic prostatectomy. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, eds. Campbell’s Urology. Philadelphia: WB Saunders 2002;3107–3129.Google Scholar
  33. 33.
    de Koning HJ, Auvinen A, Berenguer SA, et al. Large-scale randomized prostate cancer screening trials: program performances in the European Randomized Screening for Prostate Cancer trial and the Prostate, Lung, Colorectal and Ovary Cancer Trial. Int J Cancer 2002;97(2):237–244.PubMedCrossRefGoogle Scholar
  34. 34.
    Donovan J, Mills N, Smith M, et al. Quality improvement report: Improving design and conduct of randomised trials by embedding them in qualitative research: Protect (prostate testing for cancer and treatment) study. Commentary: presenting unbiased information to patients can be difficult. BMJ 2002;325:766–770.PubMedCrossRefGoogle Scholar
  35. 35.
    Holmberg L, Bill-Axelson A, Helgesen F, et al. A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer. N Engl J Med 2002;347(11):781–789.PubMedCrossRefGoogle Scholar
  36. 36.
    Stanford JL, Feng Z, Hamilton AS, et al. Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study. JAMA 2000;283(3):354–360.PubMedCrossRefGoogle Scholar
  37. 37.
    Talcott JA, Rieker P, Propert KJ, et al. Patient-reported impotence and incontinence after nerve-sparing radical prostatectomy. J Natl Cancer Inst 1997;89(15):1117–1123.PubMedCrossRefGoogle Scholar
  38. 38.
    Holzbeierlein J, Peterson M, Smith JA Jr. Variability of results of cavernous nerve stimulation during radical prostatectomy. J Urol 2001;165(1):108–110.PubMedCrossRefGoogle Scholar
  39. 39.
    Walsh PC, Marschke P, Catalona WJ, et al. Efficacy of first-generation Cavermap to verify location and function of cavernous nerves during radical prostatectomy: a multi-institutional evaluation by experienced surgeons. Urology 2001;57(3):491–494.PubMedCrossRefGoogle Scholar
  40. 40.
    Walsh PC, Marschke P, Ricker D, Burnett AL. Use of intraoperative video documentation to improve sexual function after radical retropubic prostatectomy. Urology 2000;55(1):62–67.PubMedCrossRefGoogle Scholar
  41. 41.
    Kim ED, Nath R, Slawin KM, Kadmon D, Miles BJ, Scardino PT. Bilateral nerve grafting during radical retropubic prostatectomy: extended follow-up. Urology 2001;58(6):983–987.PubMedCrossRefGoogle Scholar
  42. 42.
    Fowler FJ, Roman A, Barry MJ, Wasson J, Lu-Yao G, Wennberg JE. Patient-reported complications and follow-up treatment after radical prostatectomy: the national Medicare experience: 1988–1990 (updated June 1993). Urology 1993;42:622–629.PubMedCrossRefGoogle Scholar
  43. 43.
    Talcott JA, Rieker P, Clark JA, et al. Patient-reported symptoms after primary therapy for early prostate cancer: results of a prospective cohort study. J Clin Oncol 1998;16(1):275–283.PubMedGoogle Scholar
  44. 44.
    Heathcote PS, Mactaggart PN, Boston RJ, James AN, Thompson LC, Nicol DL. Health-related quality of life in Australian men remaining disease-free after radical prostatectomy. Med J Aust 1998;168(10):483–486.PubMedGoogle Scholar
  45. 45.
    Catalona WJ, Carvalhal GF, Mager DE, Smith DS. Potency, continence and complication rates in 1,870 consecutive radical retropubic prostatectomies. J Urol 1999;162(2):433–438.PubMedCrossRefGoogle Scholar
  46. 46.
    Rabbani F, Stapleton AM, Kattan MW, Wheeler TM, Scardino PT. Factors predicting recovery of erections after radical prostatectomy. J Urol 2000;164(6):1929–1934.PubMedCrossRefGoogle Scholar
  47. 47.
    Walsh PC, Marschke P, Ricker D, Burnett AL. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000;55(1):58–61.PubMedCrossRefGoogle Scholar
  48. 48.
    Begg CB, Riedel ER, Bach PB, et al. Variations in morbidity after radical prostatectomy. N Engl J Med 2002;346(15):1138–1144.PubMedCrossRefGoogle Scholar
  49. 49.
    Eastham JA, Kattan MW, Riedel E, et al.Variations among individual surgeons in the rate of positive surgical margins in radical prostatectomy specimens. J Urol 2003;170(6 pt 1):2292–2295.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 2007

Authors and Affiliations

  • Mark R. Feneley
    • 1
  • Roger S. Kirby
    • 2
  1. 1.Institute of Urology and NephrologyUniversity College London and UCLH, Foundation TrustLondonUK
  2. 2.The Prostate CentreLondonUK

Personalised recommendations