Pfannenstiel incision for radical retropubic prostatectomy as a surgical and cosmetic alternative to the midline or laparoscopic approach: A single center study

OBJECTIVES: The Pfannenstiel incision is not a very common approach for radical retropubic prostatectomy (RPE). This study is primarily dealing with the approach to the prostate. MATERIAL AND METHODS: A 10–12 cm Pfannenstiel incision was made 2 fingers above the pubic bone. The rectus sheath was opened transversally and dissected from the rectus muscle. The muscle was further on divided in the midline; otherwise, the operation was performed the same way as the retropubic radical prostatectomy described by Walsh [1]. The wound closure was performed in several layers, and the skin was stapled. RESULTS: In a series of 163 RPEs, we achieved excellent cosmetic results. Four patients developed subcutaneous hematomas, two of them required surgical intervention, and 3 patients developed infections that were effectively treated with antibiotics. CONCLUSIONS: Our experience with the Pfannenstiel incision approach for radical retropubic prostatectomy was very positive. The approach provides good exposure, heals well with a cosmetic scar, and facilitates hernia repair through the same approach if needed.