TRANSURETHRAL INCISION VERSUS RESECTION OF THE PROSTATE FOR SMALL TO MEDIUM BENIGN PROSTATIC HYPERPLASIA

Objective To compare the effects of transurethral incision and resecti on of the prostate in patients with small to medium benign prostatic h yperplasia. Patients and methods Patients were assessed preoperatively using the Madsen-Iversen symptom score, post-void residual urine volu me, urinary now and cystoscopy. Those eligible for the study were rand omized to undergo either transurethral incision or resection of the pr ostate, Follow-up visits were scheduled at 2-3, 6, 12, 24 and 60 month s post-operatively with an assessment by symptom score and urinary now rate; most patients also underwent cystoscopy at 24 and 60 months. Re sults The maximum urinary flow rate was significantly higher in those undergoing resection than incision at all but the last follow-up visit s. Cystoscopy 24 months after surgery showed adhesions between the lat eral lobes, closed incisions or obstructing prostatic lobes in most of the patients undergoing incision, but not in those resected (P<0.001, chi-square test). During follow-up, a second transurethral procedure a as carried out for persistent or recurrent symptoms, combined with a maximum urinary now rate of <10.0 mL/s, in 10 patients who underwent incision and in three who were resected (P=0.039, chi-square test). Co nclusion Transurethral resection is preferable to transurethral incisi on of the prostate in the treatment, of small to medium benign prostat ic hyperplasia.