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Abstract

Robotic retropubic prostate surgery has improved our knowl-edge of anatomy with respect to the prostatic and pelvic fasciaeas well as the neurovascular bundles.1This knowledge not onlyhas served us in the laparoscopic-based operations but is also trans-ferable to the open retropubic technique. However, oncological2and functional results of laparoscopic or open retropubic tech-niques are not significantly superior to the “open” technique ofradical perineal prostatectomy, a procedure that has changed littlesince it was first described by Young in 1905.3Although sur-geons are able to visualize and spare the neurovascular bundlesbilaterally in the retropubic approach, the overall erectile satis-faction rate was not more than 27% in a recent contemporaryseries.4With respect to the immediate return of continence aftercatheter removal, perineal prostatectomy achieves this withoutthe need for additional reconstructive maneuvers. This is achieved,owing to the minimum disturbance of the supportive anatomi-cal structures during perineal prostatectomy.