ABSTRACT
The introduction of the anatomical approach to Radical Retropubic Prostatectomy (RRP) by Walsh brought several advantages including better control of the dorsal venous complex, decreased intraoperative blood loss, preservation of the neurovascular bundles, and decreased incontinence rates. Rectal injury is a recognized, but unlikely complication of radical prostatectomy. Most large series report a 1% to 5% incidence. The most common nerve-related injury during RRP is transection of the obturator nerve during pelvic lymph node dissection or stretch injury from retractor positioning. Medical complications are a major part of any major pelvic surgery. Myocardial infarction is a relatively rare complication of RRP with the reported incidence ranging from 0.1% to 0.7%. Lymphocele formation is a recognized complication of pelvic surgery. Lymphoceles occur when afferent lymphatic channels have been transected without complete occlusion with hemoclips. The surgical factors influencing postoperative potency include patient selection, use of unilateral versus bilateral nerve-sparing approach, and time since surgery.
