Transurethral resection of prostate via perineal urethrostomy: follow-up report

A controlled, prospective clinical study was undertaken to determine the incidence and cause of urethral strictures after transurethral resection. Patients were assigned to one of three groups. Group A consisted of patients in whom it was considered preferable to perform prostatic resection through perineal urethrostomy; therefore, these were excluded from randomization. All other patients were randomized using a sealed envelope method into Group B who underwent resection via perineal urethrostomy and Group C who underwent resection via the entire urethra. Strictures occurred in 16.4 per cent of 85 patients in Group C and in 2.27 per cent of 88 patients in Group B; a statistically significant difference (p less than 0.01). It was concluded that strictures result from the trauma of the urethroscope via the entire urethra and not from the use of indwelling catheters. Perineal urethrostomy is the preferred route for prostatic resection and is mandatory whenever there is any question about the acceptability of the urethra to the resectoscope.