Anatomic approach to radical perineal prostatectomy.

The recent development of the laparoscopic pelvic lymphadenectomy has obviated the need for open transabdominal surgery for the staging of prostate cancer. In addition, it has become clear that all patients undergoing surgical treatment of localized prostate cancer do not require lymphadenectomy. This has led to the resurgence of the perineal approach to prostate surgery. This operation has been proven to be an effective cancer operation, having low associated morbidity and mortality. An increased understanding of pelvic anatomy has allowed the perineal approach to match the retropubic approach in efficacy and complication rate. Thus, this article serves to integrate an anatomic description of pelvic anatomy with the surgical technique of perineal prostatectomy.