Surgical Treatment of Prostate Cancer [chapter]

Mark R. Feneley, Roger S. Kirby
Urological Cancers in Clinical Practice  
Surgery for prostate cancer has evolved, with the main purpose of curing one of the most common male malignancies at an early stage in its natural history, and preventing the morbidity otherwise associated with unchecked disease progression to more advanced, incurable stages. The operation by which this may be achieved, radical prostatectomy, advanced considerably during the 20th century through developments in anatomical knowledge and surgical experience. It is now a routine surgical procedure
more » ... in urological oncology carried out through a range of surgical approaches, each with its own advantages and disadvantages. The first radical prostatectomy operations were done through a perineal approach, adapted from contemporaneous techniques for stone surgery. Theodore Bilroth is credited with the first radical prostatectomy, carried out in 1866; however, the use of this operation was slow to develop owing to its considerable morbidity and mortality. In 1905, Hugh Hampton Young [1] at the Johns Hopkins Hospital, Baltimore, Maryland, described the surgical technique for radical perineal prostatectomy and his results. This was the only definitive treatment available for prostate cancer at that time, preceding Huggins' important work on hormone sensitivity of this disease by 40 years. His technique and its description enabled surgeons to carry out prostatectomy for cure of prostate cancer with substantially lower mortality than previously possible (17%), and a 5-year cure rate of 62% [2]. Incontinence, stricture, fistula, and erectile impotence were nevertheless common and bothersome complications.
doi:10.1007/978-1-84628-507-3_2 fatcat:mc6ccvkejfae7lirul7sb2aqzy