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Perineal Prostatectomy

Removal of the prostate through the perineal region (between the scrotum and anus).

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Perineal Prostatectomy?

Perineal prostatectomy is the surgical treatment of prostate cancer in which the prostate is removed through the perineum, the area between the scrotum and the anus. It is an alternative to the retropubic approach and avoids abdominal surgery.

The approach is advantageous in morbidly obese patients, those with prior abdominal surgery and in low-risk prostate cancer that does not require pelvic lymph node dissection. Operative time and blood loss are lower.

Disadvantages include greater technical difficulty in nerve-sparing techniques and the inability to perform simultaneous pelvic lymph node dissection. As robotic surgery has become widespread, the perineal approach is used less often.

Symptoms

Diagnosis of low- to intermediate-risk prostate cancer
Morbid obesity (difficulty with the retropubic approach)
Previous lower abdominal surgery
Cancer detected on biopsy with elevated PSA
Prostate cancer with Gleason score 6-7
Clinical stage T1-T2 prostate cancer

Risk Factors

Risk of rectal injury (1-3%)
Erectile dysfunction (nerve sparing more difficult)
Risk of incontinence
Perineal wound infection
Anastomotic stricture
Fecal incontinence (rare)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Surgical option counseling at prostate cancer diagnosis
  • Need for an alternative approach because of morbid obesity
  • Postoperative wound problems or urinary incontinence
  • Suspicion of PSA recurrence

Treatment Methods

01
Radical perineal prostatectomy
02
Laparoscopic pelvic lymph node dissection (if needed, as a separate session)
03
Nerve-sparing technique (in suitable cases)
04
Vesicourethral anastomosis
05
Postoperative pelvic floor muscle exercises (Kegel)
06
Oncologic follow-up with PSA monitoring

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.