Friday, October 5, 2012

RESULTS AFTER PROSTATECTOMY


Patients after radical prostatectomy should have an undetectable PSA level. Systemic PSA detection (>0.2 ng/mL) is indicative of recurrent local or systemic disease. The risk of biochemical recurrence is dependent on the local extent of tumor (organ confined vs. extracapsular penetration), invasion of seminal vesicles or lymph nodes and Gleason sum score.  However, Gleason score and extent of local disease in the prostatic specimen provides a far more accurate means of estimating the risk of disease recurrence (Pound et al. 1997).
Results for return of urinary control after prostatectomy vary greatly from surgeon to surgeon in different series, urinary control returns for 75-98% of patients postoperatively. Return of erectile function may take up to 12-18 months, and achievement of erections adequate for vaginal penetration and climax occur in 40-80% of men in selected series, based on the number of neurovascular bundles preserved, age of the patient, preoperative erectile function, and extent of tumor.

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