Radical retropubic prostatectomy

Radical retropubic prostatectomy
ICD-9-CM	60.4, 60.5
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Radical retropubic prostatectomy is a surgical procedure in which the prostate gland is removed through an incision in the abdomen. It is most often used to treat individuals who have early prostate cancer. Radical retropubic prostatectomy can be performed under general, spinal, or epidural anesthesia and requires blood transfusion less than one-fifth of the time. Radical retropubic prostatectomy is associated with complications such as urinary incontinence and impotence, but these outcomes are related to a combination of individual patient anatomy, surgical technique, and the experience and skill of the surgeon.

Radical retropubic prostatectomy was developed in 1945 by Terence Millin at the All Saints Hospital in London. The procedure was brought to the United States by one of Millin's students, Samuel Kenneth Bacon, M.D., adjunct professor of surgery, University of Southern California, and was refined in 1982 by Patrick C. Walsh at the James Buchanan Brady Urological Institute, Johns Hopkins Medical School. It can be performed in several different ways with several possible associated procedures. The most common approach is to make an incision in the skin between the umbilicus and the top of the pubic bone. Since initial description by Walsh, technical advancements have been made, and incisional length has decreased to 8–10 cm (well below the belt-line). The pelvis is then explored and the important structures such as the urinary bladder, prostate, urethra, blood vessels, and nerves are identified.

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