Authors: Cyril Kamadjou, Divine Enoru Eyongeta, Annie Kameni Wadeu, Charlotte Mounga Mu Nkotte, Jerry Kuitche, Bertin Njinou, Fru Angwafo.
Objectives: This study sought to evaluate the functional and oncological outcomes of laparoscopic radical prostatectomy (LRP) using the extraperitoneal approach in a specialised urology centre in Cameroon.
Methods: We analysed the medical records of 45 patients who underwent radical prostatectomy over a 5-year period, from 2015 to 2020. Data were collected through structured data extraction forms and analysed using Statistical Package for Social Sciences (SPSS) version 20.0. The level of statistical significance was set at p < 0.05.
Results: The mean age of the population was 62.13 (SD: 6.02; range: 51–78) years, with 71.1% of the patients being less than 65 years old. The mean duration of follow-up was 31 months. Of the 45 patients, 30 (69.8%) had clinical-stage cT2 cancers. D’Amico’s high-risk group represented 28 (65.1%) patients, which was the most common. The mean initial total PSA was 22.47 ± 18.12 ng/mL, while the mean PSA volume was 58.39 ± 23.74 mL. The mean operating time was 127.54 ± 37.64 minutes. Seven (15.5%) patients had nerve-sparing procedures. Five (11.11%) patients developed postoperative complications, with 2 (40%) patients having a UTI and 1 (20%) patient developing anaemia requiring blood transfusion. No perioperative death was recorded. pT2 cancers made up 40.0% (18 patients) of all cancers. Longterm complications included urinary incontinence (33 (73.3%) patients), erectile dysfunction (42 (93.3%) patients), and biochemical recurrence (12 (26.67%) patients). Postoperative outcomes were similar across different age groups and D’amico risk groups.
Conclusion: The primary goal of radical prostatectomy is the surgical cure of prostate cancer. Using the extraperitoneal laparoscopic approach, good cancer control was obtained, though post-op sexual function was compromised in the majority of patients. Considerations related to surgeon expertise, patient preferences, and access to advanced surgical technologies should be taken into account when evaluating the broader public health implications of adopting LRP as a standard treatment option for prostate cancer.
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