ABSTRACT
Radical perineal prostatectomy (RPP) is the oldest approach for the removal of the prostate gland due to cancer. Unlike many of the newer forms of prostatectomy namely the robotic and laparoscopic prostatectomies, the complications of perineal prostatectomy are well described and relatively predictable. Rectal injuries have been shown to occur more frequently in cases of RPP than in RRP. Blood loss during RPP is usually minimal. In essentially all comparative studies done between RPP and RRP, the most significant difference across all series is the decreased blood loss associated with RPP. A unique morbidity to RPP is lower extremity neuropraxia. The etiology is presumed to be undue pressure on the peroneal nerve due to positioning. Urinary leak after perineal prostatectomy is an uncommon complication. This is due to the direct visualization of the urethrovesical anastomosis and the tying of these sutures under direct vision.
