Early and late complications of radical retropubic prostatectomy: Experience in a single institution

Background: Radical retropubic prostatectomy is one of the first-line treatments for clinically organ-confined prostatic cancer. However, some studies have reported the morbidity of this procedure. We retrospectively assessed the incidence of complications of radical retropubic prostatectomy in our institution. Methods: We reviewed 123 consecutive medical charts of prostate cancer patients who underwent radical retropubic prostatectomy between 1988 and 2001 at our institution. We evaluated intraoperative complications, early complications within 1 month postoperatively, and late complications, including anastomotic stricture and urinary incontinence. Results: The median age of patients was 66 years (range, 53 to 74 years) and median follow-up duration was 44.0 months (range, 2 to 157 months). None of the patients died due to surgery-related causes. Intraoperative complications included rectal injuries in six patients (4.9%) and ureteral injury in one patient (0.8%). As for late complications, anastomotic strictures were observed in 16 patients (13.8%), and stress urinary incontinence that persisted for more than 12 months was observed in 13 patients. The estimated continence recovery rate at 12 months was 87.3%. Multivariate analysis did not reveal any predictive factor for anastomotic stricture. However, the blood loss volume and period of surgery were significant predictive factors of continence recovery. Conclusions: Radical retropubic prostatectomy was safely performed, though there were various intra- or postoperative complications that were adequately managed. Early recovery of continence was related to the blood loss volume and the surgery period. Adequate surgical experience and a meticulous technique to avoid excessive bleeding are important factors for an early recovery.