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Radical retropubic prostatectomy after transurethral prostatic resection.

In 16 patients who underwent radical retropubic prostatectomy because of adenocarcinoma of the prostate after previous transurethral resection, the difficulty of the operation, the morbidity rate, and the survival time were evaluated. Eleven patients had tumours staged A2, 5 patients tumours staged B1. Duration of the operation and blood loss were almost similar to the group of patients who had not had prior transurethral resection of the prostate. The impotence rate was 100% due to difficulties preparing and preserving the neurovascular bundle. Only 1 patient had stress incontinence. One patient died after 2 years with rapid tumour progression, 1 patient shows local recurrence. Radical prostatectomy may be performed safely with an acceptable morbidity rate following transurethral resection of the prostate.

Adenocarcinoma↗

Transurethral electrovaporization of the prostate versus transurethral prostatic resection: a comparison of postoperative hemorrhage.

OBJECTIVES: To determine the acute and delayed hemorrhage rate of transurethral electrovaporization of the prostate (TEVP) versus standard transurethral resection of the prostate (TURP). METHODS: A retrospective review of 524 consecutive patients who underwent TURP and 302 consecutive patients who underwent TEVP was conducted. The indications for both procedures were identical and based on history, physical examination, American Urological Association symptom score, and uroflowmetry. Parameters of evaluation included the incidence of both initial and delayed hemorrhages, the time until a delayed bleed occurred, blood transfusion rates, and the average length of stay in hospital after a bleed. RESULTS: The overall hemorrhage rate for TURP and TEVP was 4.8% and 4.0%, respectively. In the TURP group, there was a 1.1% incidence of acute bleeds and 3.6% incidence of delayed bleeds. For the TEVP group, 0.3% had an acute hemorrhage, and 3.6% were readmitted for clot retention. The average length of time from original discharge to readmission was 12.9 days for the TURP group with a mean repeat stay of 5.7 days. For the TEVP group, the average interval to readmission was 15.4 days with a stay of 3.1 days. CONCLUSIONS: The overall rate of hemorrhage for the TEVP group was slightly lower than for the TURP group due to fewer acute bleeds. However, the incidence of delayed bleeds and clot retention between the two was identical at 3.6%. Because of improved hemostasis intraoperatively with similar functional results in the long term as shown by other investigators, we foresee TEVP continuing as a viable alternative to TURP.

Acute Disease↗

[Sexual function after transurethral prostate resection].

The possible effects of transurethral resection of the prostate were investigated in a prospective trial. 46 patients who underwent surgery for benign prostatic hyperplasia were recruited. All patients had to have a sexual partner and had to be sexually active within 3 months prior to surgery. Sexual function was assessed with the Rust and Golombok Inventory of Sexual Satisfaction (GRISS). Statistical analysis of GRISS scores exhibited a significant decrease in the erectile capacity 6 months after surgery. However, only 2 men were impotent and unable to perform sexual intercourse. 41 men developed retrograde ejaculation which was reported to interfere with sexual satisfaction in 16 men and 9 of their female partners.

Aged↗