Minimal Incision Radical Prostatectomy (Perineal Prostatectomy)

Advantages of RPP over Laproscopic or Open Prostatectomy:
1. Requires only a small 3 inch incision which is hidden under the scrotum instead of multiple small incisions on the abdomen which traverse the abdominal cavity.

2. Avoidance of major muscle groups and the abdominal cavity (peritoneum). As a result there is a quicker return of normal bowel function and resumption of a normal diet postoperatively.

3. Less pain and patient convalescence. Most of our patients require only a single injection of pain medication in the recovery room, and thereafter require only pills to manage postoperative pain.

4. Less blood loss. In the most recent series of more than 250 consecutive patients, less 1 % required a blood transfusion.

5. Shorter term catheterization postoperatively. Our patients require a catheter for only 1 week postoperatively.

6. Shorter hospital stay. 99.5% of our patients stay only 23 hours or less in the hospital.

7. Quicker return of bowel function. Since we do not have to operate through the abdominal cavity, there is less of a chance of ileus or sleepy bowels postoperatively, which can cause painful abdominal distension and prolong hospital stay. Virtually all of our patients are taking oral liquids the night of the surgery and a regular breakfast the next morning.

8. Shorter operative time. Our average length of procedure is 70- 80 minutes, compared to 2 ½ to 3 hours for the average robotic prostatectomy. This results in lower hospital costs, lower anesthetic complications, and a reduced rate of major complications such as blood clots and pulmonary emboli.

9. Better open operative visualization provides for a precise, watertight anastomosis (hookup) between the bladder and urethra after the prostate is removed. This means a quicker return to continence (normal urinary control).

10. Avoidance of scar tissue from previous abdominal procedures. Laparoscopic or retropubic procedures need exposure of the prostate throught the abdominal cavity. Previous surgeries can cause scarring or adhesions which can prolong operative time and make exposure/ dissection of the prostate more difficult. A perineal approach come right down on the prostate without having to go through a previously-operated area.

11. Low complication rate. In the past 5 years, less than 1% of patients have had a significant postop complication requiring a longer hospital stay or later admission to the hospital within 30 days of surgery.

12. Excellent preservation of erections postoperatively. Our long term results are similar to those large series of patients who have had laparoscopic or open procedures.

13. Operative experience. Our surgeons have been performing this operation for 10 years. We have done more than 1000 cases and when you have your operation, it will be with two experienced surgeons as opposed to a single staff surgeon and a resident (if you are at a teaching hospital).