HOW COMPLETE IS A TRANSURETHRAL RESECTION OF THE PROSTATE

Objective To determine the completeness of transurethral resection of the prostate (TURP). Patients and methods The prostate volume of 432 p atients was measured by transrectal ultrasonography (TRUS) before they underwent a TURF performed by one of three consultant urological surg eons. The prostate tissue collected at resection was weighed, multipli ed by 1.2. to compensate for 'shrinkage', and the amount of tissue rem oved expressed as a percentage of the pre-operative prostate volume de termined by TRUS (resection ratio), The patients were categorized into groups based on pre-operative prostate size. Results The mean weight of prostate tissue resected was 25.6 g. Resection ratios increased wit h prostate size, with the largest occurring in prostates of 71-110 g. The surgeon did not resect more than 50% of the gland volume in any gr oup. Conclusion This study counters the theory that a complete resecti on of the prostate is routinely achieved. The endoscopic appearances p robably imply a complete resection of the adenoma but a considerable v olume of the gland remains. This has important implications for the de tection of prostate carcinoma at TURF and for the staging of the disea se.