The morbidity of radical prostatectomy for multifocal stage I prostatic adenocarcinoma

During a 25 yr period, 33 patients with stage I multifocal prostatic adenocarcinoma underwent radical prostatectomy. Carcinoma was present in 81% of the specimens. The operative mortality was 3%. Pelvic recurrence, rectal injury and urethrovesical stricture each occurred in 9% of the cases. 15% of the patients were totally incontinent and 42% had stress incontinence. One patient required combined retropubic and perineal approaches to remove the specimen. The safest interval between the first and the radical procedure was 6 wk or more. The 5 and 10 yr relative survival rates were 100%. The best candidate for a radical prostatectomy after transurethral prostatic resection or suprapubic enucleation prostatectomy is one with a thick surgical capsule in whom the first procedure precedes the radical procedure by at least 6 wk.