Transurethral incisions of the prostate under local anaesthesia in high-risk patients: a pilot study

Transurethral incision of the prostate under local anaesthesia was performed in 27 patients with symptoms of infravesical obstruction and an estimated prostatic weight of 20 g or less. Local anaesthesia (lidocaine 1%) was infiltrated transurethrally under the urethral prostatic mucosa using a special needle adaptable to the resectoscope. Pain control, assessed with a scoring system, was judged as good or very good by the majority of patients (25) and fair by the remaining 2 patients. No patient required conversion to another type of anaesthesia. The results of surgery as estimated by symptom score, uroflowmetry, and patients' personal evaluation were good. Transurethral incision of the prostate can be satisfactorily performed under local anaesthesia; this may be especially applicable to high-risk surgical patients. Incision of the prostate in the treatment of benign prostatic hyperplasia may be performed as an outpatient procedure in selected cases.