The Effect of Prostatectomy on Upper Urinary Tract Function

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)

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Transurethral Versus Transvesical Prostatectomy

Meyhoff

Nordling

Hald

1985

Scandinavian Journal of Urology and Nephrology

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The present randomized study evaluated the physiological strain in transurethral (TURP) versus transvesical (TVP) prostatectomy in 75 patients with clinically benign, medium-sized prostatic enlargement. In both groups 5 patients had coincidental prostatic carcinoma. During TURP a suprapubic trocar was inserted for irrigation with 1.5% glycine. Antibiotics were given to patients with preoperative urinary tract infection and postoperatively tranexamic acid was administered to all patients. Coexisting diseases which might increase the operative risk were equally present in TURP and TVP patients. No patient died in connection with the operative procedures. Median duration of anaesthesia for TVP was 95 min and for TURP 60 min (p less than 0.001). Almost identical operative blood loss was seen in the two groups. However, more blood transfusion were given to TVP patients. Following discharge, more episodes of bleeding were registered in the TURP group, but no significant difference was observed in number of secondary operations for bleeding. In the TVP group, more patients had pulmonary complications, elevated rectal temperature as well as antibiotic treatment and 34% of these patients developed wound infection. Secondary operations before discharge were also more frequently undertaken in TVP patients. No differences between the two groups were seen pre- or postoperatively with respect to electrolyte, protein, creatinine and haemoglobin values. In the patients with incidental prostatic carcinoma a TURP was the most gentle procedure. With respect to physiological strain a TURP is clearly to be preferred over a TVP for obstructive clinically benign, medium-sized prostatic hyperplasia.

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The Effect of Prostatectomy on Upper Urinary Tract Function

Cited by 4 publications

References 12 publications

Is Benign Prostatic Hyperplasia a Risk Factor for Chronic Renal Failure?

Is Benign Prostatic Hyperplasia a Risk Factor for Chronic Renal Failure?

Clinical Evaluation of Transurethral Versus Transvesical Prostatectomy

Transurethral Versus Transvesical Prostatectomy

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