Abstract: Objective:To compare the efficacy and safety of antegrade and retrograde radical retropubic prostatectomy in the treatment of localized prostate cancer.Methods:Seventy patients with localized prostate cancer were randomly divided into the antegrade and retrograde groups(35 cases each group),and treated with antegrade and retrograde radical retropubic prostatectomy,respectively.The age,prostate volume,prostate-specific antigen,Gleason score,peroperative bleeding,operation time,postoperative pathological staging,following-up time,operation complication,and postoperative maximum urinary flow rate,sexual life recovery,biochemical recurrent time and number between two groups were compared.Results:No death in two groups was found.The differences of the age,prostate volume,prostate-specific antigen,Gleason score,pathological staging,following-up time,operation complication,and postoperative maximum urinary flow rate,biochemical recurrent number and sexual life recovery between two groups were not statistically significant(P>0.05).The operation time and peroperative bleeding in antegrade group were significantly less than those in retrograde group(P<0.01),and the time of detecting maximum urinary flow and biochemical recurrent time in antegrade group were significantly shorter than those in retrograde group(P<0.05 to P<0.01).Conclusions:Both antegrade and retrograde radical retropubic prostatectomy in the treatment of localized prostate cancer are safe and effective,and the peroperative bleeding and operation time in patients treated with antegrade radical retropublic prostatectomy are less and shorter compared with retrograde radical retropublic prostatectomy.