RADICAL PROSTATECTOMY IN A COMMUNITY PRACTICE

Abstract

We report the experience of a community based urologist with anatomical retropubic radical prostatectomy. We compared outcome data with that reported experience at several well-known academic institutions. Between May 1986 and December 2000, 382 consecutive patients underwent anatomical radical retropubic prostatectomy performed by a single community based urologist. Charts were reviewed to determine the positive margin rate, urinary continence, potency, hospitalization and the prostate specific antigen (PSA) recurrence rate. The positive margin rate was 9% overall but in the last 5 years it was 7% compared with 7% to 40% in previous studies at academic institutions. The urinary continence rate was 90% overall and 93% in the last 5 years when excluding men older than 70 years old, compared with 85% to 94% in the academic urological literature. The potency rate after the bilateral nerve sparing technique was 79% compared with 54% to 86% in academic series. Average hospitalization in the last 5 years was 1.5 days. Overall PSA recurrence rate and the rate of PSA recurrence as a function of preoperative PSA, postoperative stage and grade were similar to those at academic institutions. Anatomical radical prostatectomy can be performed at nonacademic institutions with results comparable to those at academic institutions.