Salvage radical prostatectomy: refinement of an effective procedure.

Salvage radical prostatectomy has undergone significant refinement over the past decade. This update on salvage radical prostatectomy will review improvements in patient selection, modifications in surgical technique, and compare the efficacy of salvage prostatectomy with that of salvage cryotherapy and brachytherapy. When performed by experienced surgeons, the procedure has a low rate of serious side effects and with modifications to surgical techniques; the risk for specific complications such as incontinence and bladder-neck contracture can be reduced or eliminated. The biochemical outcome after salvage prostatectomy appears superior to the biochemical outcome after salvage cryotherapy or brachytherapy. Salvage radical prostatectomy may cure approximately 50% of well-selected patients.