| Authors | Charles Cini John Sciberras K German |
| Abstract | A review of 10 consecutive patients with localised prostate cancer who underwent a Radical Prostatectomy at St. Lukes Hospital from 1997 2003 is presented. The initial diagnosis was confirmed by transrectal prostate biopsy. Preliminary isotope bone scan and CT scan of the abdomen and pelvis showed no evidence of overt metastatic disease. Method and results: The patients that were selected for the operation were all young (mean age 57.5 years, range 50 63) and had minimal co-morbidity. The average PSA at presentation was 14 ng/ml (range 5.7 33). The average duration of the operation was 5 hours (including frozen section), and mean length of stay was 6 days. Patients were discharged from hospital with an-in-dwelling urethral catheter for three weeks. The mean period of follow-up is now 42 months (range 18 - 72 months). 9/10 patients remain alive and well (one patient died from metastatic disease 3 years post-operatively). The current PSA level is 0.1 ng/ml in 8 patients whilst one patient has a slow rising PSA which now stands at 1.64 ng/ml. This patient will be referred for radiotherapy shortly. Two patients developed calf DVTs post-operatively. Continence and potency are recognized consequences of this type of operation. 7 patients have full continence, whilst 2 have minor stress incontinence. One patient required placement of an artificial urinary sphincter. Only one patient has natural erections, whilst one patient is potent with the help of intracavernosal injections. Discussion: This personal experience shows that the operation is safe and effective at controlling prostate cancer and has acceptable morbidity. The operation is considered for young men with localized prostate cancer. It is likely that the number of radical prostatectomies will increase in the future as PSA screening will diagnose more cases of cancer at an earlier stage of the disease. |
Published in: | |
| Journal | Malta Medical Journal |
| Volume | Volume 15 (suppl) |
| Pages | - |
| Date | |
| Link to journal | |
| Key words | radical prostatectomy, localised prostate cancer, safety, audit, urology |