Transurethral Prostatectomy in the 1990s: Safety, Efficacy and Skilled Experience

We retrospectively reviewed the cases of transurethral prostatectomy benign prostatic hyperplasia. We defined the morbidity, hospitalization and urethral catheter time, complication and operator's skilled experience and compared to transurethral prostatectomy in the historical series.

A retrospective chart review of 720 consecutive patients who underwent tranasurethral prostatectomy between 1990 and 1999 at our institution for symptomatic benign prostatic hyperplasia was performed. Perioperative and late postoperative morbidity and their risk factors, hospitalization and urethral catheter time, operator's skilled experience were analyzed. The objective cases were divided by operator's experience into 5 groups, and compared in each group.

Patients were identified with an average of 66 years(range 45 to 88). Significant co-morbidity(2 or more co-morbid disease processes) was identified preoperatively in 22.1% of the patients. The most common indication for transurethral prostatectomy was prostatism only(63%). Average weight of resected tissue was 18.6gm. There was no perioperative patient mortality. Blood transfusion rate was 6.9%. The rates of early and late postoperative complications were 13.7% and 6.2%. Total average hospital stay was 5.5 days and 5.3 days from 1995 through 1999. Average preoperative symptom score was 23.8(range 10 to 35) and postoperative symptom score was 9.5(range 3 to 30) with an average follow up of 42 months(range 6 to 44 months).

In the 1990s complications of transurethral prostatectomy were relatively lower than rates in historical series. The average hospital stay and urethral catheter time have steadily decreased during the last 10 years. Transurethral resection of prostate could provide relief of lower urinary tract symptoms with high safety rate and low complication rate. Our study suggest that technique of trnasurthral resection is improving step by step by accumulating experience of operation and stabilized skillful technique will be achieved after experience of more than 150 cases.