Long-term results of open transvesical prostatectomy from a contemporary series of patients.
OBJECTIVE
To provide information about the long-term efficacy of transvesical prostatectomy from a contemporary series of patients. When comparing minimally invasive procedures with open prostatectomy, the data for the latter are usually provided from old studies or from recent ones performed in developing countries. However, this procedure is still used frequently for large-size prostates.


METHODS
During a 5-year period, 232 patients with large (greater than 75 g) prostates underwent open transvesical prostatectomy for symptomatic benign prostatic hyperplasia. Patient charts were retrospectively reviewed for preoperative and postoperative International Prostate Symptom Scores, postvoid residual urine volumes, maximal flow rates, early and late postoperative complications, and the need for reoperation. The preoperative International Prostate Symptom Score, postvoid residual urine volume, and maximal flow rate were compared with the corresponding postoperative data at 8 to 12 months and at the last follow-up visit.


RESULTS
Complete data evaluation was possible for 151 patients, with a mean follow-up of 41.8 +/- 15.6 months. Improvement in International Prostate Symptom Score, postvoid residual urine volume, and maximal flow rate was statistically significant (P <0.001) at 8 to 12 months and remained statistically significant at the last follow-up visit. Long-term complications included bladder neck contraction in 5 (3.3%) occurring at a mean of 10 months (range 5 to 17), urethral strictures in 1 (0.6%), and meatal stenosis in 2 (1.3%) of 151 patients. Re-operation was required in 6 patients (3.9%).


CONCLUSIONS
Transvesical prostatectomy in a contemporary series of patients proved to be successful, with a low rate of complications. Its success has a durable effect and only rarely was a corrective procedure necessary. This approach should be included in the list of possible treatments to discuss with the patient with a large prostate.
Second Department of Urology, Sismanoglio Hospital, University of Athens, Athens, Greece.
Ioannis
I
Varkarakis
Zacharias
Z
Kyriakakis
Athanasios
A
Delis
Vasilios
V
Protogerou
Charalambos
C
Deliveliotis
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000706:statistics & numerical data; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology; D014563:Urodynamics