Radical prostatectomy is indicated for localized prostate cancer, involves total removal of the prostate and surrounding tissue including the seminal vesicles and ampullae of the vas deferens, and is classically associated with a bilateral pelvic lymph node dissection. The operation is performed using a perineal or retropubic approach. The earlier perineal approach initially produced less morbidity and lower blood loss; however, the retropubic approach allows for a bilateral pelvic lymphadenectomy and a nerve sparing operation that can also provide for improved potency compared to the perineal method. In addition, rectal or anal problems are rare during or after a retropubic approach but may be more likely with a perineal operation. Therefore, the radical retropubic prostatectomy (RRP) has been performed with higher frequency in recent years. Using a small incision (8 cm), a mini-laparotomy (mini-lap) radical retropubic prostatectomy can provide the advantages of minimally invasive surgery with the nerve sparing component as well. In addition, the minilap radical retropubic prostatectomy compares favorably with laparoscopic radical prostatectomy, which is usually performed via an intra-abdominal approach under general anesthesia and requires an excess of 4 hours of surgery. The mini-lap retropubic prostatectomy can be performed in half the time under regional anesthesia with similar hospitalization and morbidity. In addition, the nerve-sparing component for potency with the laparoscopic approach remains more certain.

Typically, indications for radical prostatectomy are patients with organ-confined disease (stage T1 and T2 disease) that are under 70 years of age and are in good medical condition.