Radical prostatectomy for prostate cancer--an experience of fifteen cases in Singapore.

ABSTRACT

Radical retropubic prostatectomy as a viable option for patients with localized prostate cancer hinges on the morbidity associated with the surgery. We assessed a group of 15 patients operated between February 1992 to September 1994 by a single surgeon to gauge the severity of short-term morbidity. Their mean age was 66.7 years (range, 40-76 years). While most of them had obstructive urinary symptoms, 4 were asymptomatic and were diagnosed by screening. Their median preoperative prostate specific antigen (PSA) was 25.9 ng/dl. The mean operative time was 110 minutes and the mean blood loss was 450 ml. One patient developed postoperative pulmonary embolism which delayed his discharge from the hospital despite routine prophylactic physical measures. The median length of hospital stay was 7 days. Eight patients had immediate total continence, while the remainder attained day-time and nocturnal continence within 1 to 3 months. Three patients had adjuvant orchidectomy. Most patients had high grade and margin positive (T3) disease but none were node positive. With a median follow-up of 7 months, none of the patients developed local or systemic recurrence. With the minimum surgical morbidity, short hospital stay and excellent continence achieved, the option of radical prostatectomy can be offered to suitable patients for curative treatment of localised prostate cancer.