DIFFERENCES IN OUTCOME OF TRANSURETHRAL RESECTION OF THE PROSTATE FORBENIGN PROSTATIC HYPERTROPHY BETWEEN 3 DIAGNOSTIC CATEGORIES

As part of a prospective cohort study of 388 men undergoing transureth ral resection of the prostate (TU RP) for benign prostatic hypertrophy , pre-operative factors and the outcome of surgery during the first po st-operative year were compared between patients in whom their surgeon felt the principal reason for operating was chronic retention (37%), acute retention (with no chronic retention) (28%), or symptomatic pros tatism (with no history of chronic or acute retention) (35%). Although in many respects the patients in the 3 diagnostic categories were sim ilar, patients with chronic retention were more likely to be younger, of higher social class and to have worse general health. Patients with acute retention were more likely to present with a urinary tract infe ction and to have electrocardiographic abnormalities, and symptomatic patients presented with more severe urinary symptoms. Minor difference s between the categories with regard to post-operative morbidity and m ortality were not statistically significant at the 5% level. However, some significant differences did exist. Patients with acute retention were more likely to experience urinary and non-urinary infections and impotence after surgery, while symptomatic patients reported less impr ovement in their health status as regards pain and social isolation. T hese results suggest that the method of categorisation is clinically v alid and a necessary distinction to make when auditing TURP.