[Transurethral incision of the prostate].
In this paper the Authors present the preliminary results of an investigation of a series of a patients with BPH who have undergone TUIP by modified monolateral incision. Post-operative complications, hospital stay and short-term urine flow values have been assessed. From June '94 to April '96 at the Department of Urology of the Hospital of Matera, 56 patients with BPH-induced cervico-urethral obstruction undergone TUIP. Their average age was 66; the average follow up was 9.5 months. Thirty-one of them ha bladder catheters. The patients were selected by ultrasonographically measured prostatic volume (< or = 30 gr). The operation was almost in all cases conducted under spinal anaesthesia. A 5-10 mm-long monolateral incision was made medial to the right urinary meatus, starting just behind the trigonal bar and going up to the pre-spyncteric region, laterally to the veru montanum. The incision was made up to the section of the muscle fibres of the trigone and those of the prostate capsule, exposing the fat. Post-operative assessment included a urine culture after 15 days as well as a urine flow measurement every three months. The operative took an average of 10.3 minutes. The catheter was removed on average after 2 days. Post-operative hospitalization lasted on average 3.9 days. No post-operative complications were encountered. Only in 3 cases in which a catheter with no Coudè tip was used, was it difficult to insert. In no case was a blood transfusion necessary. Six patients with normal pre-operative sexual activity maintained their normal ejaculation. Of the 29 patients that had got through the 3-months' follow-up, seven who had been catheterized before the operation, showed, along with an average volume of urine of 236.7 cc, a maximum flow value of 10.8 ml/sec., an average flow of 6.8 ml/sec. and a bladder emptying time of 36.8 sec. The other 22 patients had an average maximum flow speed of 20.5 ml/sec. (+121.5%), an average flow of 10.3 (123.9%), an emptying time of 33 sec. (-8.8%) with an average volume of urine of approximately 300 cc (+58.9%). Thus, in view of the noteworthy post-operative improvement in the symptomatology, both in subjective and objective terms, as well as the low rate of complications and the considerably reduced costs, TUIP may be considered a valid surgical alternative for treatment of BPH with adenomas weighing < or = 30 gramis in selected patients.
Traficante
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Cattedra di Urologia, Università degli Studi di Bari.
Disabato
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Grieco
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Ditaranto
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G
Grande
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N
Vaccaro
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A
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000601:surgery*