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Transurethral versus transvesical prostatectomy. Physiological strain.

H H Meyhoff, J Nordling, T Hald

    Scandinavian Journal of Urology and Nephrology
    |January 1, 1985
    PubMed
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    Transurethral prostatectomy (TURP) is a gentler procedure than transvesical prostatectomy (TVP) for benign prostatic hyperplasia, showing less physiological strain and fewer complications. TURP is preferred for medium-sized prostates.

    Area of Science:

    • Urology
    • Surgical Oncology

    Background:

    • Benign prostatic hyperplasia (BPH) affects a large number of aging men.
    • Surgical interventions like transurethral prostatectomy (TURP) and transvesical prostatectomy (TVP) are common treatments.
    • Evaluating the physiological strain of different surgical approaches is crucial for patient outcomes.

    Purpose of the Study:

    • To compare the physiological strain between TURP and TVP in patients with medium-sized benign prostatic enlargement.
    • To assess complication rates and recovery patterns associated with each surgical method.

    Main Methods:

    • A randomized study involving 75 patients with medium-sized prostatic enlargement.
    • Comparison of operative duration, blood loss, transfusion requirements, and postoperative complications between TURP and TVP groups.

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  • Inclusion of patients with incidental prostatic carcinoma in both groups.
  • Main Results:

    • TURP had a significantly shorter anesthesia duration (60 min) compared to TVP (95 min).
    • TVP patients experienced more pulmonary complications, fever, antibiotic use, and wound infections (34%).
    • While TURP had more post-discharge bleeding episodes, overall secondary operations for bleeding were similar; TVP required more pre-discharge secondary operations.

    Conclusions:

    • Transurethral prostatectomy (TURP) demonstrates less physiological strain and a lower complication profile compared to transvesical prostatectomy (TVP).
    • TURP is the preferred surgical option for patients with obstructive, clinically benign, medium-sized prostatic hyperplasia.
    • TURP is also the more suitable procedure for patients with incidental prostatic carcinoma.