Clinical evaluation of transurethral versus transvesical prostatectomy. A randomized study

Area of Science:

• Urology
• Surgical Oncology

Background:

• Benign prostatic hyperplasia (BPH) is a common condition in aging men.
• Surgical interventions like transurethral prostatectomy (TURP) and transvesical prostatectomy (TVP) are standard treatments.
• Evaluating long-term clinical outcomes and complications is crucial for patient management.

Purpose of the Study:

• To compare the clinical efficacy and safety of TURP versus TVP.
• To assess symptom scores, incontinence, sexual function, and complications at 6 months post-surgery.
• To identify differences in outcomes between the two surgical approaches for BPH.

Main Methods:

• Randomized study involving 75 patients with medium-sized obstructive BPH.
• Clinical evaluation at 6 months post-TURP or TVP.
• Assessment of total, obstructive, and irritative symptom scores.
• Monitoring for urinary incontinence, sexual activity, retrograde ejaculation, urinary tract infections, and urethral strictures.

Main Results:

• No statistically significant differences in overall symptom scores between TURP and TVP.
• Both procedures effectively relieved obstructive symptoms, but high incidences of irritative symptoms were noted.
• Higher rates of retrograde ejaculation and urethral strictures were observed in the TVP group.
• Incontinence duration and frequency were comparable, with a slight trend towards more incontinence after TURP.

Conclusions:

• TURP and TVP offer comparable 6-month clinical outcomes for obstructive BPH.
• Persistent irritative symptoms and sexual side effects, particularly retrograde ejaculation, are common after both procedures.
• Urethral strictures represent a significant postoperative complication, especially following TVP.