[Elements of the early diagnosis and staging of prostatic cancer. Functional results of radical surgery. Apropos of 50 complete prostatectomies].

The authors report a series of 50 radical prostatectomies and analyse and discuss the elements of: early diagnosis of adenocarcinoma: 63% of patients did not have a strictly normal digital rectal examination, 70% had abnormal ultrasonography, 73% has a PSA assay greater than 10. Suspicious signs were absent in 17% of cases, but present in 83% of cases (one sign), 63% of cases (two signs) and 40% of cases (three signs). Ultrasound guided biopsy of suspicious zones (on rectal examination or on ultrasonography) and in adjacent zones by dividing the prostate into quadrants has an increasing diagnostic yield (77% of the last thirty cases, 100% of the last fifteen cases). Staging frequently underestimates the exact volume of the tumour and the state of the prostatic capsule. MRI using a high power magnetic field apparatus seems to improve the accuracy of preoperative staging. Operative results were excellent in terms of mortality (nil), morbidity (6% of cases) and functional results for continence (recovered within one month) and sexual activity (satisfactory in 73% of cases) when Walsh's technique was able to be applied.