Perioperative nursing implications of radical perineal prostatectomy.

Improvements of surgical techniques for radical prostatectomy, including nerve-sparing methods, have made surgery the preferred treatment for prostate-confined tumors. Perineal prostatectomy is tolerated well by patients, especially the elderly and those who are at high risk. Blood loss during perineal prostatectomy versus retropubic prostatectomy is minimal. Additionally, the perineal approach provides the surgeon with better exposure for anastomosing the bladder neck to the urethra. The bowel does not have to be manipulated in the perineal approach, which minimizes paralytic ileus. Perioperative nurses must become familiar with the technique, positioning, and equipment necessary to care for patients undergoing radical perineal prostatectomy.