Preoperative estimation of the size of prostatic adenomas

In a retrospective study the postoperative weight of one hundred prostatic adenomas was compared with the preoperative estimated size, based on rectal digital palpation. As a basis for the choice between transurethral and transvesical resection the adenomas were classified by digital palpation in three weight groups: less than 20 g. 20--40 g and more than 40 g. The objective was to avoid transvesical resection in small adenomas and transurethral resection in large ones, weighing more than 40 g. No adenomas weighing less than 20 g were removed transvesically. About one fourth of the adenomas removed transurethrally weighed more than 40 g. Forty-five per cent of the adenomas were placed erroneously into the 20 g group. Rectal digital palpation is a very unreliable method of assessing prostatic size, however, very small adenomas can be identified. Urethrocystoscopy can be of aid in identifying the very large ones.