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Radical perineal prostatectomy is an alternative to the retropubic, robotic-assisted or the laparoscopic approach and it is one of the oldest surgical procedures for prostate cancer, but its use has declined over the past 30 years. The desire for lower morbidity, short hospital stay, and decreased costs has resulted in a renaissance of radical perineal prostatectomy. The combination of low morbidity, short hospital stay, and low economic costs brought to a renaissance of radical perineal prostatectomy.