The retropubic approach has recently become the method of choice for radical prostatectomy. This has been particularly evident since the 1970s, when open staging lymphadenectomy became an important part of the diagnostic workup, as both procedures could be carried out concurrently via the anterior approach. However, the development and rapidly increasing use of laparoscopic lymphadenectomy may signal a return to the perineal approach in certain cases. Alternatives to radical prostatectomy, including radiotherapy and interstitial brachytherapy, may also have their place. The audience was asked to comment on their own practices and the factors that would influence their decisions.