Surgical Treatment for Benign Prostatic Hyperplasia (BPH): Critical Assessment of our Experience

Abstract

Surgery is the ideal treatment in patients with benign prostatic hyperplasia (BPH). TURP is the most common: 90% of the 400,000 prostatectomies performed each year in the USA for BPH, are by transurethral approach and 10% by traditional surgical approach. From January 1992 to December 1993 the authors treated 267 patients for symptomatic BPH (72 TUIP, 117 TURP, 78 adenectomies). Response to treatment was checked with uroflowmetry and subjective evaluation of symptoms. 195 patients could be evaluated (51 TUIP, 85 TURP, 59 adenectomies). Obstructive symptoms persisted in 38 patients (19.4%) and uroflowmetry was pathological in just 15 (7.7%). The cause in most cases was related to post-surgery complications, which were comparable to those reported in literature. Irritative symptoms upon removal of the obstruction persisted in 36 patients (18.4%). These apparent failures of surgical therapy are critically discussed.