Reoperative surgery for prostate cancer

The best treatment for prostate cancer is an individualized choice specific to each patient. The decision to undergo prostate cancer surgery is based on several factors including the patient's preoperative health status, ability to gain oncologic control, and the patient's previous surgical history. When considering a patient for radical prostatectomy (RP), previous prostate surgery must be considered. Reoperative surgery for prostate cancer can be associated with technical challenges that may impact the long-term functional and oncologic outcomes. Previous prostate procedures can vary from treatment of benign prostatic hyperplasia (BPH) to primary local therapy for prostate cancer. Thus, one must be aware of the added challenges and risks that such surgical history portends and relate this information to the patient prior to radical prostatectomy. In this chapter, we seek to outline how previous prostate surgery impacts the technical aspects and outcomes of both primary and salvage radical prostatectomy in patients with adenocarcinoma of the prostate.