Localized prostate carcinoma. Surgical management.

Total prostatectomy in the properly selected patient will provide disease-free survival rates comparable to the expected survival in similarly aged men for up to 30 years of observation (Figure 4). Patients who undergo total prostatectomy accept a very small risk of long-term permanent complications or mortality, and effective treatment is available for most complications. The morbidity and costs associated with hormone refractory metastatic prostate cancer are significant, with bone pain and anemia from bone marrow invasion, bladder dysfunction (retention, incontinence, and hematuria), urinary tract infection, anorexia, and uremia from obstructed ureters being common sequelae in the months before death. In the properly selected patient, minimal risk is incurred from total prostatectomy, the potential complications are well defined and manageable, and long-term disease-free survival is seen in most patients.