Clinical Evaluation of Transurethral Versus Transvesical Prostatectomy

Abstract

The present randomized study gives an evaluation of clinical results 6 months following transurethral (TURP) and transvesical (TVP) prostatectomy in 75 patients with clinical benign medium-sized obstructive prostatic hyperplasia. Following treatment of postoperative urethral stricture, urinary tract infection and residual bladder stones no statistically significant differences could be demonstrated in the effects of TURP and TVP on a calculated total symptom score nor on the individual obstructive and irritative prostatic symptoms. In both groups the obstructive symptoms were best relieved whereas rather high incidences of irritative symptoms were seen at follow-up. The median duration of incontinence following TURP was 10 weeks compared to 6 weeks following TVP but the difference, however, was insignificant. At follow-up also more patients in the TURP group had urinary incontinence although only one patient in this group with benign histology had daily urinary urge incontinence. Stress incontinence was observed in two patients with malignant histology. Persistent detrusor instability was suggested partly responsible for the follow-up irritative symptoms. In both groups and especially in the TVP group a small decrease in frequency of sexual activity was seen 6 months postoperatively. Seventy per cent of TVP patients and 57% of TURP patients reported retrograde ejaculation at follow-up. More urinary tract infections were seen in the TVP group, however, the differences were insignificant. Twenty-five per cent of TVP patients and 17% of TURP patients developed urethral strictures postoperatively and judged from flowmetry most strictures were obstructive.(ABSTRACT TRUNCATED AT 250 WORDS)

Subjective and Clinical Results after Transurethral Resection and Suprapubic Prostatectomy in Benign Prostatic Hypertrophy

“…Similar results after TUR were reported by Bruskewitz et al [4] with urinary stream complaints in 20% and residual urine sensations in 17% of cases. The quota of patients with complete inconti nence after TUR was 1.8% which corresponds to mod ern literature data [12,14], Meyhoff et al [15] found a higher quota of incontinence and a longer postoperative incontinence period after TUR than after SP, which could be confirmed in our study. Whereas Rivain and Cukier [12] observed persistent urgency after TUR in 60% of cases, this quota decreased in our study from 54.4 to 17.5%.…”

“…In our study, SP showed definitely less late postoperative complications than TUR. The litera ture data as for late complications vary in a wide range [4,14,15,[18][19][20][21], Concerning the prostatic size mea sured by rectal sonography, substantially less patients in the SP group showed a prostatic rest or recurrence. The postoperative developement of uroflow data following SP was much more satisfactory.…”

Long-Term Clinical Reliability of Transurethral and Open Prostatectomy for Benign Prostatic Obstruction: A Term of Comparison for Nonsurgical Procedures

“…Surgery has been unanimously con sidered the first-choice therapy for patients with bladder outlet obstruction due to BPH [1], transurethral resection of the prostate (TURP) being certainly the most fre quently performed urological operation with well-known effectiveness in improving urinary symptoms [2], Open prostatectomy is performed less frequently as it is usually selected only for large glands. It is, however, equally effec tive [3]. Surgical treatment of BPH has been a matter of controversy in the recent scientific literature for 2 rea- [16], transrectal prostatic ultrasonography and determination of residual urine volume by catheter.…”

Invasive and Minimally Invasive Treatment Modalities for Lower Urinary Tract Symptoms: What Are the Relevant Differences in Randomised Controlled Trials?

“…The technique was initially described by Nesbit in 1943 [26]. Analysis of randomised studies vs. open surgery suggest a mean symptomatic improvement of 90%; overall, large variation is reported in non-randomised studies ranging from 56 to 100% (mean 82.7%) [27, 28, 29, 30, 31, 32, 33, 34, 35]. Quality of life appeared to be positively modified by transurethral surgery as proven by the EuroQol (EQ) quality of life measure and the Nottingham health profile [36].…”

“…Quality of life appeared to be positively modified by transurethral surgery as proven by the EuroQol (EQ) quality of life measure and the Nottingham health profile [36]. Flow rate improvement over 100% was described in most studies (range 53–188) although a value of 88.2% was found in a randomised series vs. open surgery from Meyhoff and co-workers [18, 27, 28, 30, 32, 34, 35, 37, 38]. Early complications range from 18 to 23% and mostly consist in intra-operative bleeding [10, 39, 40, 41].…”