CLINICAL EXPERIENCE OF RETROPUBIC PROSTATOVESICULECTOMY FOR BENIGN PROSTATIC HYPERTROPHY

Abstract

Various operative methods have been proposed to treat benign prostatic hypertrophy, but the results of these procedures have several problems to be discussed clinically because they remove adenoma only. Some of them are prolonged postoperative hematuria, secondary hemorrhage, postoperative long term existence of urinary tract infection, interference with normal micturition, especially nocturnal frequency and occult carcinoma.
To resolve these problems, I have carried out a new surgical method “Retropubic Prostato-Vesiculectomy” to remove adenoma as a mass involving a part of the posterior capsule and seminal vesicle in 205 consecutive cases of prostatic hypertrophy.
The therapeutic results were as follows:
1. Patients age ranged from 49 to 88 years with an average of 70.8±6.0 years.
2. One hundred and five patients (51.4 per cent) had associated disease or a significant medical history.
3. The operating time ranged from 56 to 140 minutes with an average of 92.7±17.5 minutes.
4. The average operative blood loss was 916±609ml.
5. Postoperative macroscopic hematuria continued for 1.9±4.2 days on the average, and none of the patients had secondary hemorrhage.
6. The urethral catheter was removed 10.59±6.03 days postoperatively on the average.
7. Postoperative pyuria continued for 5.83±3.10 weeks on the average.
8. Postoperative stay in hospital ranged from 11 to 130 days with an average of 27.5±14.6 days.
9. After two months postoperatively, nocturnal frequency was reduced to be almost normal.
10. Postoperative complication rate was 30.7 per cent in this series.
11. Mortality rate was 0.98 per cent in this series (2 deaths resulted from brain hemorrhage).
12. Ten patients (4.9 per cent) had carcinoma of the prostate on pathological examination of the tissue. None of them represented recurrence except one who was revealed to be stage C histologically.