Clinical and therapeutic aspects of benign prostatic hyperplasia based on a series of 1,280 operated cases.

Between 1989 and 1996, 1,280 patients aged 41 to 100 years were operated fo r BPH. 70% of patients were treated at the stage of complications such as a cute urinary retention, haematuria, bladder stones or renal failure. 549 pa tients (42.9%) were treated by transvesical prostatectomy (TVP), 668 patien ts (52.18%) underwent transurethral resection (TURP) and only 63 (4.92%) we re treated by bladder neck incision (BNI). Early postoperative complication s essentially consisted of infections: wound infection (15%), followed by v esico-cutaneous fistula (2%), epididymo-orchitis (0.7%) and urinary tract i nfection (1.5%). Late postoperative assessment revealed retrograde ejaculat ion in 100% of cases after transvesical surgery, 80% of cases after TURF an d almost no cases (4%) after BNI. The permanent urinary incontinence rate w as 1.18% after TURF and 1.0% after transvesical surgery. The shortest mean postoperative stay was 5 days in the BNI group versus 12.5 days' after tran svesical surgery. Finally, the postoperative mortality, essentially due to septic shock and myocardial infarction, was (0.8%). The BPH complication ra te is proportional to the delay in diagnosis and management. Transurethral resection remains the most effective treatment with the lowest morbidity.