Which prostatectomy approach is rarely used due to risk of injury to surrounding structures?

Which prostatectomy approach is rarely used due to risk of injury to surrounding structures?

• A. Laparoscopic
• B. Perineal
• C. Retropubic
• D. Suprapubic

Answer: (B)

The route chosen to reach the prostate determines how close the surgeon operates to surrounding pelvic structures. The perineal approach is entered through the perineum, which brings the instrument path very near the rectum and anal sphincter and offers limited visibility and access to the pelvic lymph nodes and neurovascular bundles. This proximity raises the risk of injuring the rectum or sphincter and makes nerve-sparing and thorough lymph node dissection more challenging. Because of these higher risks and the potential for significant complications, this approach is rarely used today. Modern methods like retropubic and laparoscopic/robotic approaches provide safer access with better preservation of surrounding structures and more complete cancer control.

The route chosen to reach the prostate determines how close the surgeon operates to surrounding pelvic structures. The perineal approach is entered through the perineum, which brings the instrument path very near the rectum and anal sphincter and offers limited visibility and access to the pelvic lymph nodes and neurovascular bundles. This proximity raises the risk of injuring the rectum or sphincter and makes nerve-sparing and thorough lymph node dissection more challenging. Because of these higher risks and the potential for significant complications, this approach is rarely used today. Modern methods like retropubic and laparoscopic/robotic approaches provide safer access with better preservation of surrounding structures and more complete cancer control.