TRANSVESICAL PROSTATECTOMY IN ELDERLY PATIENTS

Purpose: We assessed the results of transvesical prostatectomy in pati ents older than 80 years. Materials and Methods: We studied 98 patient s 80 to 90 years old who underwent transvesical prostatectomy between 1986 and 1993, including those with a large prostate (preoperative est imated weight more than 80 gm.), numerous or large cystolithiasis and large bladder diverticulum, which are indications for open prostatecto my. Clinical data were obtained by chart review. Results: The indicati ons for surgery were urinary retention in 53 patients (54%), severe ob structive urinary symptoms in 18 (18.4%), cystolithiasis in 17 (17.3%) , prostatic bleeding in 10 (10.2%) and bladder diverticulum in 2 (2%). Accompanying diseases were present in 69 patients (70.6%), including ischemic heart disease in 41 (42%), diabetes mellitus in 17 (17.3%) an d arterial hypertension in 14 (14.3%). A total of 59 patients (60.2%) underwent surgery while under general anesthesia and 39 (39.8%) receiv ed regional anesthesia. Average operative time was 62 minutes. Of the patients 40 (40.8%) received 1, 14 (14.3%) received 2 and 2 (2%) recei ved 4 units of blood. No postoperative deaths or life threatening comp lications were noted. The immediate postoperative complications includ ed urinary tract infection in 20 patients (20.5%), wound infection in 3 (3.0%) and orchiepididymitis in 3 (3.0%). Postoperative mild to mode rate incontinence was noted in 2 patients (2.0%). Bladder neck constri ction and urethral strictures occurred in 4 (4.1%) and 3 (3.0%) patien ts, respectively. Conclusions: Transvesical prostatectomy can be perfo rmed safely in elderly patients with a low morbidity rate.