All patients (n=16,524) who underwent RPE in public hospitals (covering 95% of all surgical procedures) in Austria between 1992 and 2003 were analysed. Patient demographics, interventions for anastomotic strictures/urinary incontinence/inguinal hernias, perioperative mortality, and overall survival (OS) were determined. Data were provided by the Austrian Health Institute (ÖBIG). For decades Austria has had a public and equal access health system with compulsory insurance coverage.

The annual number of RPEs increased from 396 in 1992 to 2640 (+666%) in 2003; the mean age at surgery declined from 64±6.3 yr (1992) to 62.0±6.7yr (2003). An endourologic intervention for anastomotic strictures was performed in 8.5% (45–49 yr: 5.8%; 70–74 yr: 10.8%). An artificial urinary sphincter was implanted in 1.6% with a 5-fold increase from the youngest (0.5%; 45–49 yr) to 2.5% in those aged 70–74 yr. Overall, 6.4% of men underwent an inguinal herniotomy after RPE. The 30-d mortality rate was 0.12%. The 5-yr OS declined from 95% in those aged 50–59 yr to 89.8% in those aged 60–69 yr to 82% in the oldest age group (70–79 yr).

This nationwide analysis describes the current standard of RPE in Austria. The perioperative mortality was low, the risk of total incontinence acceptable, and the OS indistinguishable to the life expectancy of the age-matched male population in Austria.

Badereddin Al-Ali Mohamad, Martin Marszalek, Clemens Brössner, Anton Ponholzer, Clemens Wehrberger, Manfred Willinger, Stephan Madersbacher

Department of Urology and Andrology, Donauspital, Vienna, Austria
Austrian Health Institute, Vienna, Austria

Accepted 13 June 2006 published online 29 June 2006.